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Related Experiment Videos

Atrial standstill: an indication for rate responsive pacing.

F Solti1, F Rényi-Vámos, T Gyöngy

  • 1Cardiovascular Surgical Clinic, Budapest, Hungary.

Pacing and Clinical Electrophysiology : PACE
|July 1, 1990
PubMed
Summary

Atrial standstill, a rare cause of slow heart rate (bradycardia), can be effectively managed with a rate-responsive pacemaker. This intervention significantly improves symptoms and quality of life for affected individuals.

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrial standstill, or atrial paralysis, is an uncommon cause of persistent bradycardia.
  • This condition is characterized by the absence of atrial mechanical and electrical activity.

Observation:

  • A 35-year-old male presented with lifelong bradycardia and recent onset of diminished working capacity and exertional dyspnea.
  • Diagnostic evaluations including chest X-ray, echocardiography, and atrial pressure monitoring showed no atrial mechanical activity.
  • Electrophysiological studies confirmed the inability to electrically stimulate the atria and record P waves.

Findings:

  • The patient exhibited a slow junctional escape rhythm of 38 beats/min.
  • Electrophysiological testing revealed non-stimulable atria and absent P waves on right atrial electrograms.

Related Experiment Videos

  • Implantation of a rate-responsive pacemaker resolved symptoms, improved exercise tolerance, and reduced heart size.

    • Implications:

    • Atrial standstill, characterized by permanent bradycardia and non-stimulable atria, is a clear indication for ventricular rate-responsive pacing.
    • Rate-responsive pacing offers a definitive solution for managing symptoms and improving functional capacity in patients with atrial standstill.
    • This case highlights the efficacy of modern pacing technology in addressing rare cardiac conditions.