Persistent isolated right atrial standstill associated with left atrial tachycardia

Atrial standstill is a rare condition, characterized by absence of atrial electrical and mechanical activity evident in surface electrocardiography echocardiography, or fluoroscopy, which is associated with unresponsiveness of atria to maximal output electrical stimulation. This condition can be present with thromboembolic complication, low cardiac output, and sometimes palpitation.

Here we presented a woman with right atrial stand still and left atrial tachycardia. It was confirmed by electrocardiogram, echocardiography, and intracardiac electrogram in basal state and during maximal output electrical stimulation. We treated her by implanting pacemaker to control bradycardia, oral calcium channel blocker to control palpitation episodes, and anticoagulation.

Atrial standstill can be present partially that can be localized in one atrium and is associated with tachycardia in the other atrium.