Severe atrial fibrosis as a cause of significant intraatrial conduction delay in a patient with scleromyositis

Krzysztof Kaczmarek; Izabela Poddębska; Michał Kałowski; Rafał Berner; Monika Zatorska-Berner; Paweł Ptaszyński; Iwona Cygankiewicz

doi:10.1016/j.jelectrocard.2019.06.012

Severe atrial fibrosis as a cause of significant intraatrial conduction delay in a patient with scleromyositis

J Electrocardiol. 2019 Sep-Oct:56:77-80. doi: 10.1016/j.jelectrocard.2019.06.012. Epub 2019 Jun 19.

Authors

Krzysztof Kaczmarek¹, Izabela Poddębska¹, Michał Kałowski¹, Rafał Berner¹, Monika Zatorska-Berner¹, Paweł Ptaszyński¹, Iwona Cygankiewicz²

Affiliations

¹ Department of Electrocardiology, Medical University of Lodz, Pomorska Str 251, 92-213 Lodz, Poland.
² Department of Electrocardiology, Medical University of Lodz, Pomorska Str 251, 92-213 Lodz, Poland. Electronic address: iwona.cygankiewicz@umed.lodz.pl.

PMID: 31325621
DOI: 10.1016/j.jelectrocard.2019.06.012

Abstract

Scleromyositis is an autoimmune disease and an overlap syndrome of scleroderma and poly/dermatomyositis. It is characterized by frequent cardiovascular involvement including heart failure, arrhythmias and conduction disturbances. We present a case of a 73-year old female patient who required an upgrade from a DDD pacemaker to cardiac resynchronization therapy due left ventricular dysfunction and permanent ventricular pacing. Electroanatomical mapping (CARTO 3D) revealed extensive right atrial fibrosis which resulted in significant delay in intraatrial conduction. Interval from atrial paced stimulus to A signal in His bundle was 364 ms, while AH and HV intervals were within normal range.

Keywords: Atrial fibrosis; Atrial lead dysfunction; Electrophysiological study; Intraatrial conduction delay; Pacemaker; Scleromyositis.

Publication types

Case Reports

MeSH terms

Aged
Arrhythmias, Cardiac / therapy
Cardiac Pacing, Artificial*
Cardiac Resynchronization Therapy*
Electrocardiography
Female
Fibrosis
Heart Atria
Humans