Implantable Cardioverter-Defibrillator Implantation in a Patient with Atrial Standstill

Yonsei Medical Journal 2009³â 50±Ç 1È£ p.156 ~ p.159

¹Ú¼Ò¶ó(Park So-Ra) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ȲÁø¿ë(Hwang Jin-Yong) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
°­¿µ¶õ(Kang Young-Ran) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
°ûÃæȯ(Kwak Choong-Hwan) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
°­¹Î°æ(Kang Min-Kyung) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
¼­¸í±â(Seo Myeong-Gi) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
¾È¿¬Á¤(Ahn Yeon-Jeong) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Á¶Á¤Çö(Cho Jung-Hyun) - °æ»ó´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç

Abstract

We report a 55-year-old female patient who presented with no P waves but with a wide QRS complex escape rhythm at 44 beats/min and prolonged QTc of 0.55 seconds on ECG. The patient had recurrence of ventricular fibrillations and loss of consciousness, and underwent defibrillation and cardiopulmonary resuscitation (CPR) several times because of cardiac arrest. The transthoracic echocardiography showed dilated cardiomyopathy and enlargement of both atria. The Doppler echocardiography documented the absence of A wave in the tricuspid and mitral valve flow. An electrophysiologic study demonstrated electrical inactivity in the right and left atria. Atrial pacing with maximum output did not capture the atria. These findings together with her electrocardiographic finding indicated atrial standstill. Sudden cardiac death was her first clinical manifestation of ventricular arrhythmia. The patient remained asymptomatic after receiving a single chamber implantable cardioverter-defibrillator (ICD) with VVI pacemaker function.

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Atrial standstill, dilated cardiomyopathy, cardiopulmonary resuscitation, sudden cardiac death
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The patient remained asymptomatic after receiving a single chamber implantable cardioverter-defibrillator (ICD) with VVI pacemaker function.
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DOI
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ICD 03
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