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Journal of Veterinary Cardiology : the... Jun 2017Persistent atrial standstill is a rare arrhythmia in both human and veterinary patients. In recent decades, cases of partial atrial standstill have been recognized in...
Persistent atrial standstill is a rare arrhythmia in both human and veterinary patients. In recent decades, cases of partial atrial standstill have been recognized in humans. We describe a case of presumptive partial atrial standstill in a Greyhound, in which there was disparate left and right atrial electromechanical function and rapid progression to congestive heart failure over the span of fourteen weeks. An atrial cardiomyopathy characterized by severe, diffuse, fibrofatty replacement of the atrial myocardium was identified histologically.
Topics: Animals; Arrhythmias, Cardiac; Cardiomyopathies; Dog Diseases; Dogs; Electrocardiography; Fatal Outcome; Female; Genetic Diseases, Inborn; Heart Atria; Heart Block
PubMed: 28314614
DOI: 10.1016/j.jvc.2017.01.003 -
Annals of Noninvasive Electrocardiology... Mar 2017Atrial standstill is a rare disorder of cardiac rhythm that is characterized by total absence of electrical activity in one or both atria. We report herein the case of a...
Atrial standstill is a rare disorder of cardiac rhythm that is characterized by total absence of electrical activity in one or both atria. We report herein the case of a patient with atrial fibrillation and symptomatic 4.0 s pauses who received a ventricular demand pacemaker. The patient later underwent mitral valve replacement with a pericardial tissue valve and the Cox-maze III procedure for symptomatic mitral stenosis and atrial fibrillation. Following surgery, he developed atrial standstill and became pacemaker dependent. The pacemaker was later revised to an atrioventricular sequential pacemaker. Twelve hours after revision, atrioventricular sequential pacing was noted and mechanical function of the atria was confirmed by Doppler echocardiography.
Topics: Atrial Fibrillation; Cardiomyopathies; Echocardiography, Doppler; Electrocardiography; Genetic Diseases, Inborn; Heart Atria; Heart Block; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; Mitral Valve Stenosis; Pacemaker, Artificial; Postoperative Complications
PubMed: 27558131
DOI: 10.1111/anec.12399 -
Journal of Cardiology Cases Nov 2016Most of the abnormal cardiac conduction system findings are atrial tachyarrhythmias in cardiac sarcoidosis. However, atrial standstill as a sick-sinus syndrome could be...
Most of the abnormal cardiac conduction system findings are atrial tachyarrhythmias in cardiac sarcoidosis. However, atrial standstill as a sick-sinus syndrome could be complicated in the case of diffuse atrial fibrosis. Herein, we present an interesting and valuable case of atrial standstill with suspected isolated cardiac sarcoidosis. < The chronic inflammation caused by isolated cardiac sarcoidosis could impair the conduction system. With atrial standstill, we recommend a comprehensive effort to investigate the potential etiology including cardiac sarcoidosis, particularly in the case of enlarged atrium and ventricular dysfunction.>.
PubMed: 30546677
DOI: 10.1016/j.jccase.2016.06.010 -
Circulation Journal : Official Journal... Jul 2016Atrial standstill is one of the important clinical consequences on the heart in severe hyperkalemia, but it occurs even at modest potassium ion elevation. The extent to... (Clinical Trial)
Clinical Trial
BACKGROUND
Atrial standstill is one of the important clinical consequences on the heart in severe hyperkalemia, but it occurs even at modest potassium ion elevation. The extent to which other factors might potentiate the electrocardiographic changes induced by hyperkalemia remains unclear.
METHODS AND RESULTS
This was a retrospective review of the data on 12,639 hospital admissions over a 15-year period. A total of 778 patients with hyperkalemia were identified, 28 of whom had atrial standstill, and had several parameters measured prior to any treatment of hyperkalemia. Patients with atrial standstill were older (P=0.036), had lower diastolic blood pressure (DBP; P<0.0001) and serum sodium concentration (P<0.0001), higher serum potassium (P<0.0001), and high prevalence of angiotensin converting-enzyme inhibitor (ACEI; P=0.009) or mineral corticoid receptor (MR)-blocker (P=0.006), compared with those without atrial standstill. On multivariate logistic regression, DBP <67 mmHg (P=0.006), serum sodium ion <135 mmol/L (P=0.006) and serum potassium ion >6.1 mmol/L (P=0.018) were identified as independent indicators of atrial standstill, after adjusting for sex, age, chronic maintenance hemodialysis, diuretics use or ACEI/angiotensin receptor blocker and MR blocker.
CONCLUSIONS
Hyponatremia and decline in DBP are associated with atrial standstill in patients with hyperkalemia. (Circ J 2016; 80: 1781-1786).
Topics: Aged; Aged, 80 and over; Arrhythmias, Cardiac; Blood Pressure; Female; Humans; Hyperkalemia; Hyponatremia; Male; Middle Aged; Retrospective Studies
PubMed: 27301330
DOI: 10.1253/circj.CJ-16-0283 -
Circulation Jun 2016The arrhythmogenesis of ventricular myocardial ischemia has been extensively studied, but models of atrial ischemia in humans are lacking. This study aimed at describing...
BACKGROUND
The arrhythmogenesis of ventricular myocardial ischemia has been extensively studied, but models of atrial ischemia in humans are lacking. This study aimed at describing the electrophysiological alterations induced by acute atrial ischemia secondary to atrial coronary branch occlusion during elective coronary angioplasty.
METHODS AND RESULTS
Clinical data, 12-lead ECG, 12-hour Holter recordings, coronary angiography, and serial plasma levels of high-sensitivity troponin T and midregional proatrial natriuretic peptide were prospectively analyzed in 109 patients undergoing elective angioplasty of right or circumflex coronary arteries. Atrial coronary branches were identified and after the procedure patients were allocated into two groups: atrial branch occlusion (ABO, n=17) and atrial branch patency (non-ABO, n=92). In comparison with the non-ABO, patients with ABO showed: (1) higher incidence of periprocedural myocardial infarction (20% versus 53%, P=0.01); (2) more frequent intra-atrial conduction delay (19% versus 46%, P=0.03); (3) more marked PR segment deviation in the Holter recordings; and (4) higher incidence of atrial tachycardia (15% versus 41%, P=0.02) and atrial fibrillation (0% versus 12%, P=0.03). After adjustment by a propensity score, ABO was an independent predictor of periprocedural infarction (odds ratio, 3.4; 95% confidence interval, 1.01-11.6, P<0.05) and atrial arrhythmias (odds ratio, 5.1; 95% confidence interval, 1.2-20.5, P=0.02).
CONCLUSIONS
Selective atrial coronary artery occlusion during elective percutaneous transluminal coronary angioplasty is associated with myocardial ischemic damage, atrial arrhythmias, and intra-atrial conduction delay. Our data suggest that atrial ischemic episodes might be considered as a potential cause of atrial fibrillation in patients with chronic coronary artery disease.
Topics: Action Potentials; Aged; Angioplasty, Balloon, Coronary; Arrhythmias, Cardiac; Atrial Natriuretic Factor; Biomarkers; Chi-Square Distribution; Constriction, Pathologic; Coronary Angiography; Coronary Circulation; Coronary Occlusion; Coronary Vessels; Electrocardiography, Ambulatory; Female; Heart Atria; Heart Conduction System; Heart Rate; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Odds Ratio; Propensity Score; Prospective Studies; Risk Factors; Time Factors; Troponin T
PubMed: 27151531
DOI: 10.1161/CIRCULATIONAHA.116.021700 -
The Canadian Veterinary Journal = La... Mar 2016Pacemakers were implanted in 4 client-owned female dogs which had persistent atrial standstill. Three dogs were alive after 14 to 39 months and 1 dog was euthanized...
Pacemakers were implanted in 4 client-owned female dogs which had persistent atrial standstill. Three dogs were alive after 14 to 39 months and 1 dog was euthanized after 10.5 years. This report demonstrates that some dogs with persistent atrial standstill can survive for extended time periods.
Topics: Animals; Cardiomyopathies; Dog Diseases; Dogs; Female; Genetic Diseases, Inborn; Heart Atria; Heart Block; Pacemaker, Artificial; Survival Rate; Treatment Outcome
PubMed: 26933268
DOI: No ID Found -
Biochimica Et Biophysica Acta Jul 2016The SCN5A gene encodes the alpha-subunit of the Nav1.5 ion channel protein, which is responsible for the sodium inward current (INa). Since 1995 several hundred... (Review)
Review
The SCN5A gene encodes the alpha-subunit of the Nav1.5 ion channel protein, which is responsible for the sodium inward current (INa). Since 1995 several hundred mutations in this gene have been found to be causative for inherited arrhythmias including Long QT syndrome, Brugada syndrome, cardiac conduction disease, sudden infant death syndrome, etc. As expected these syndromes are primarily electrical heart diseases leading to life-threatening arrhythmias with an "apparently normal heart". In 2003 a new form of dilated cardiomyopathy was identified associated with mutations in the SCN5A gene. Recently mutations have been also found in patients with arrhythmogenic right ventricular cardiomyopathy and atrial standstill. The purpose of this review is to outline and analyze the following four topics: 1) SCN5A genetic variants linked to different cardiomyopathies; 2) clinical manifestations of the known mutations; 3) possible molecular mechanisms of myocardial remodeling; and 4) the potential implications of gene-specific treatment for those disorders. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.
Topics: Action Potentials; Animals; Cardiomyopathies; Genetic Markers; Genetic Predisposition to Disease; Genetic Therapy; Heart Rate; Humans; Mutation; Myocytes, Cardiac; NAV1.5 Voltage-Gated Sodium Channel; Phenotype; Risk Factors; Ventricular Remodeling
PubMed: 26916278
DOI: 10.1016/j.bbamcr.2016.02.014 -
Korean Circulation Journal Sep 2015Isolated left ventricular noncompaction (LVNC) is a rare cardiomyopathy with morphologic characteristics of two distinct myocardial layers i.e., thin compacted...
Isolated left ventricular noncompaction (LVNC) is a rare cardiomyopathy with morphologic characteristics of two distinct myocardial layers i.e., thin compacted epicardial and thick noncompacted endocardial layers. The noncompacted myocardium consists of prominent ventricular trabeculae and deep intertrabecular recesses. It can lead to arrhythmias, heart failure or systemic embolisms. Electrocardiographic patterns of patients with LVNC are various and non-specific; however, the most common findings are intraventricular conduction delay, left ventricular hypertrophy, and repolarization abnormalities. We reported the first case, to the best of our knowledge, of a 29-year-old man who had recent cerebral infarction and incidental LVNC with spontaneous left atrial standstill.
PubMed: 26413113
DOI: 10.4070/kcj.2015.45.5.432 -
Research in Cardiovascular Medicine Nov 2014Atrial standstill is a rare condition, characterized by absence of atrial electrical and mechanical activity evident in surface electrocardiography echocardiography, or...
INTRODUCTION
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.
CASE PRESENTATION
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.
CONCLUSIONS
Atrial standstill can be present partially that can be localized in one atrium and is associated with tachycardia in the other atrium.
PubMed: 25785252
DOI: 10.5812/cardiovascmed.25173 -
Turk Kardiyoloji Dernegi Arsivi : Turk... Oct 2013Despite advances in device closure for atrial septal defect, post-closure heart failure remains a clinical problem in adult patients but is seen only rarely in children....
Despite advances in device closure for atrial septal defect, post-closure heart failure remains a clinical problem in adult patients but is seen only rarely in children. An eight-year-old boy, who had been followed by a local pediatrician with the diagnosis of diabetes mellitus and congenital heart disease, was consulted to us for cardiac re-evaluation. Electrocardiography demonstrated absent P waves, and echocardiography revealed enlargement of the right ventricle and both atria and secundum atrial septal defect. With the diagnosis of atrial standstill, secundum atrial septal defect and thiamine-responsive megaloblastic anemia, acute heart failure developed after transvenous closure of the atrial septal defect, which improved dramatically with thiamine and supportive treatment.
Topics: Anemia, Megaloblastic; Cardiomyopathies; Child; Genetic Diseases, Inborn; Heart Atria; Heart Block; Heart Failure; Heart Septal Defects, Atrial; Humans; Male; Thiamine
PubMed: 24164997
DOI: 10.5543/tkda.2013.63295