[Idiopathic dilatation of the heart atrium with complete auricular paralysis]

The authors report the case of a patient with idiopathic dilatation of the auricles and complete atrial paralysis associated with absence of excitability of the atrial muscle. Repeated echocardiograms over a period of three months demonstrated dilatation of the auricles and ventricles with the development of mitral and tricuspid incompetence. The role played by the junctional bradycardia in the ventricular dilatation is discussed and the patient was explored haemodynamically with varying rates of ventricular pacing. In view of the improvement in the haemodynamic parameters, a cardiac pacemaker was inserted. After a follow-up of one year, the ventricular chambers have returned to normal and the mitral and tricuspid incompetence has regressed, while the atrial muscle continues to dilate. The patient is currently asymptomatic with no medical treatment.