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Familial atrial standstill with coexistent atrial flutter
S Balaji1, J Till, E A Shinebourne
1Royal Brompton Hospital, London, United Kingdom.
Pacing and Clinical Electrophysiology : PACE
|September 23, 1998
Summary
Familial atrial standstill requires more than just bradycardia protection. A child with this condition experienced syncope from atrial flutter, necessitating His-bundle ablation for effective treatment.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Genetics
Background:
- Familial atrial standstill is a rare inherited condition affecting the heart's upper chambers.
- Patients often require pacemakers for slow heart rates (bradycardia).
Observation:
- A pediatric patient with familial atrial standstill and a ventricular pacemaker presented with syncope.
- The syncope was caused by rapid, irregular atrial activity (atrial flutter).
Findings:
- His-bundle ablation successfully treated the atrial flutter and resolved the syncope.
- Bradycardia pacing alone was insufficient to prevent atrial flutter-induced syncope in this case.
Implications:
- This case highlights the potential inadequacy of bradycardia pacing in managing complex arrhythmias in familial atrial standstill.
- His-bundle ablation may be a necessary adjunctive therapy for symptomatic atrial flutter in these patients.
- Further research into genetic factors and comprehensive management strategies for familial atrial standstill is warranted.