Persistent isolated right atrial standstill associated with left atrial tachycardia

Abstract

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.

Atrial standstill in a pediatric patient with associated caveolin-3 mutation

“…Prior cases of AS have been reported in the adult literature with tachyarrhythmias in Brugada syndrome due to SCN5A mutation and catecholeminergic polymorphic ventricular tachycardia associated with RYR2 mutation. 4 , 5 Jorat et al 6 reported a case of isolated right AS with left atrial tachycardia in a 32-year-old female patient. Like our patient, she presented with chronic fatigue and dyspnea suggestive of bradycardia and a progressive course.…”

Atrial standstill presenting as cerebral infarction in a 7-year-old girl

“…Atrial standstill is a rare arrhythmia defined by the absence of mechanical and electrical activity in the atria. It was first described in 1946 by Chavez et al 1 The diagnostic criteria include: (a) abnormal or absent P-waves in surface and intracavity electrocardiograms (ECGs). If present, atrial activity is slow and erratic, with a prolonged, low-amplitude and low-frequency electrogram; (b) evidence of atrial asystole, that is, the absence of A-waves in jugular venous pulse and right atrial pressure tracings; (c) supraventricular QRS morphology; (d) immobility of the atria on fluoroscopy and (e) inability to stimulate the atria electrically.…”

“…If present, atrial activity is slow and erratic, with a prolonged, low-amplitude and low-frequency electrogram; (b) evidence of atrial asystole, that is, the absence of A-waves in jugular venous pulse and right atrial pressure tracings; (c) supraventricular QRS morphology; (d) immobility of the atria on fluoroscopy and (e) inability to stimulate the atria electrically. 2–5 Few cases of atrial standstill have been described in children. 6–9 We report a case of atrial standstill in a 7-year-old girl presenting with cerebral infarction with expressive aphasia and central facial palsy.…”