Korean Circ J.  2022 Sep;52(9):717-719. 10.4070/kcj.2022.0094.

A Case of SCN5A Mutation-Associated Isolated Left Atrial Standstill and Ischemic Stroke

• Kang DS
• Khmao P
• Oh J
• Pak HN

• KMID: 2532938
• DOI: http://doi.org/10.4070/kcj.2022.0094

Figure

• 

  Figure 1 Examinations which were conducted prior to electrophysiological study. Cerebral magnetic resonance imaging in April 2020 (A). Documented paroxysmal atrial fibrillation in July 2020 (B). Electrocardiogram in March 2021. The red square showed PR interval 240 ms (C).aVF = augmented vector foot; aVL = augmented vector left; aVR = augmented vector right.

• 

  Figure 2 Echocardiography which was conducted in March 2021. Serial change of mitral inflow pattern and loss of A-wave since September 2014.

• 

  Figure 3 Electrophysiologic study and ECG. Intracardiac electrogram during sinus rhythm with HV interval 73 ms. In contrast to the absence of endocardial signals in LA posterior wall and pulmonary vein, SVC showed relatively preserved signals in intracardiac electrograms (A). The left atrial voltage map with final ablation site at RA (B). A genotype pedigree representing first-degree relatives (C). Follow-up Holter showing paroxysmal complete AV block in November 2021 (D).AV = atrioventricular; aVF = augmented vector foot; HV = His-ventricular; LA = left atrial; NSR = normal sinus rhythm; RA = right atrium; SVC = superior vena cava.

Reference

1. Shaw TR, Northridge DB, Francis CM. Left atrial standstill in a patient with mitral stenosis and sinus rhythm: a risk of thrombus hidden by left and right atrial electrical dissociation. Heart. 2003; 89:1173. PMID: 12975410.

2. Duncan E, Schilling RJ, Earley M. Isolated left atrial standstill identified during catheter ablation. Pacing Clin Electrophysiol. 2013; 36:e120–e124. PMID: 21070263.