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Persistent atrial standstill--clinical, electrophysiological, and morphological study.
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
Pacing and Clinical Electrophysiology : PACE
|August 1, 1991
Summary
Persistent atrial standstill (PAS) is a rare cardiac condition. Endomyocardial biopsies revealed underlying pathologies like myocarditis and amyloidosis in affected patients.
Area of Science:
- Cardiology
- Electrophysiology
- Pathology
Background:
- Persistent atrial standstill (PAS) is a rare condition defined by absent atrial electrical and mechanical activity.
- Diagnosis involves surface and intracavity electrograms, showing inability to stimulate the atria.
Observation:
- Four patients (18-60 years) with PAS were evaluated.
- One patient presented with isolated right atrial standstill.
- Right ventricular endomyocardial biopsy (RV-EMB) was used to investigate atrial pathology due to the impossibility of right atrial biopsy.
Findings:
- RV-EMB revealed inflammatory myocarditis in two patients, amyloidosis in one, and myocardial hypertrophy with fibrosis in one.
- Three patients required permanent pacemakers.
- One patient with amyloidosis experienced sudden cardiac death; another was lost to follow-up.
Implications:
- This study highlights the utility of RV-EMB in diagnosing underlying causes of PAS.
- Identifying pathologies like myocarditis and amyloidosis is crucial for patient management and prognosis.
- Further research is needed to understand the long-term outcomes and optimal treatment strategies for PAS.