Document Detail

Clinical and electrophysiological characteristics of atrial standstill.
MedLine Citation:
PMID:  7659578     Owner:  NLM     Status:  MEDLINE    
To clarify the clinical and electrophysiological characteristics of atrial standstill (AS) we studied 11 patients (7 males and 4 females), whose average age was 62 years and who were followed over a period of 4-179 months. Underlying heart disease was present in nine patients and two cases were idiopathic. Major clinical symptoms in the 11 cases included Adams-Stokes attacks, and dyspnea on exertion. In the standard 12-lead ECGs obtained on admission, the P wave was absent in six cases. Atrial flutter (AF) was noted in 3, atrial fibrillation (Af) in 1, and multifocal atrial tachycardia in 1. In some cases, the ECG initially showed AF or Af, and was transformed after several years into ectopic atrial tachycardia or an ectopic atrial rhythm with a markedly decreased amplitude of the P wave. Finally, the P wave disappeared over a prolonged period. When intracardiac mapping was performed, the atrial electrograms tended to diminish at the site of high, mid-lateral right atrium (RA). Electrograms were remained present in the vicinity of the tricuspid valve (TV) annulus. A repeated mapping and pacing study conducted in two patients revealed that the "silent" area spread toward the lower site of RA. During the average follow-up period of 64 months, four patients died. The interval until death in one patient with myocarditis was 6 months, and in another with dilated cardiomyopathy (DCM) it was 8 months. It appears that the atrial muscular lesion starts in the high lateral RA and progresses toward the lower RA, then to the vicinity of the TV annulus. A diffuse and progressive disturbance may occur not only in the atrial muscle, but also in the atrioventricular conduction system in patients with AS who had progressive myocarditis or DCM.
Y Nakazato; Y Nakata; T Hisaoka; M Sumiyoshi; S Ogura; H Yamaguchi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  18     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-10-02     Completed Date:  1995-10-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1244-54     Citation Subset:  IM    
Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis*,  mortality,  physiopathology,  therapy
Atrial Function*
Cardiac Pacing, Artificial
Heart Catheterization
Heart Conduction System / physiopathology*
Heart Diseases / physiopathology
Heart Valve Diseases / physiopathology
Middle Aged
Myocarditis / physiopathology
Pacemaker, Artificial

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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