Drago F, Fazio G, Di Pino A, Silvetti MS. The total absence of atrial automaticity in a child with sinus node dysfunction.
NATURE CLINICAL PRACTICE. CARDIOVASCULAR MEDICINE 2007;
4:513-7. [PMID:
17712364 DOI:
10.1038/ncpcardio0966]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 05/21/2007] [Indexed: 05/16/2023]
Abstract
BACKGROUND
A routine sports evaluation identified constant alternation between a junctional and idioventricular rhythm in a 9-year-old child. During exercise testing, electrography demonstrated that the child was in junctional rhythm without any apparent P waves, and had a reduced increase in heart rate. Endocardial atrial pacing captured the atrium and demonstrated that atrioventricular conduction was normal, but the recovery time of the ectopic rhythm was very long. Three-dimensional electrophysiological mapping revealed 1:1 retrograde homogeneous conduction through the right atrium.
INVESTIGATIONS
Electrocardiography, Holter monitoring, echocardiography, exercise stress testing, atrial pacing, three-dimensional electroanatomical mapping of the right atrium and genetic testing.
DIAGNOSIS
Sinus node dysfunction.
MANAGEMENT
Pacemaker implantation was postponed until a later stage in the patient's development.
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