6533b820fe1ef96bd1279c14
RESEARCH PRODUCT
The total absence of atrial automaticity in a child with sinus node dysfunction
Alfredo Di PinoGiovanni FazioMassimo Stefano SilvettiFabrizio Dragosubject
Malemedicine.medical_specialtyAccelerated idioventricular rhythmElectrocardiographyHeart Conduction SystemHeart RateInternal medicineHeart ratemedicineHumanscardiovascular diseasesHeart AtriaAtrium (heart)ChildSinoatrial Nodemedicine.diagnostic_testSinoatrial nodebusiness.industryGeneral Medicinemedicine.diseaseIdioventricular rhythmmedicine.anatomical_structureAnesthesiacardiovascular systemCardiologyElectrocardiography AmbulatoryElectrical conduction system of the heartCardiology and Cardiovascular MedicinebusinessElectrophysiologic Techniques CardiacElectrocardiographyJunctional rhythmAccelerated Idioventricular Rhythmdescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2007-09-01 |