Mesothelioma of the AV node: potential utility of pacing

Mesothelioma of the atrioventricular node are rare benign tumors with well-described potential for resulting in sudden death. The presentations have varied: the majority of patients have been predominantly female aged 15 to 40, dying suddenly; however, other patients have had documented heart block for many decades and a noncardiac cause of death. A 19-year-old female expired after presenting with ventricular fibrillation and was subsequently discovered to have a mesothelioma involving the AV node. Although high degree heart block is present in many patients, most episodes of sudden death probably are secondary to ventricular tachyarrhythmias. Either form of dysrhythmia may potentially benefit from ventricular pacing.