Ebstein anomaly associated with unusual conduction delay and sick sinus syndrome

Circ J. 2004 Jul;68(7):719-21. doi: 10.1253/circj.68.719.

Abstract

A 64-year-old man was admitted to our hospital because of palpitation, dyspnea on effort, and facial edema. The echocardiographic diagnosis was Ebstein anomaly. Although the 12-lead electrocardiogram showed an atrial rate of 150 beats/min and no typical flutter wave, the electrophysiological study showed counterclockwise rotation of excitation along the tricuspid annulus. Because of sinus arrest and syncope, a permanent pacemaker was implanted, but the right atrium was not captured by electrical stimulation at 5 V/0.4 ms, except for the orifice of coronary sinus, and the intracardiac P wave was only 0.2 mV or less. This is a rare case of Ebstein anomaly characterized by unusually prolonged conduction in the atrium, the basis of which was global myocardial damage, including the ventricles.

Publication types

  • Case Reports

MeSH terms

  • Ebstein Anomaly / complications*
  • Ebstein Anomaly / diagnostic imaging
  • Ebstein Anomaly / physiopathology
  • Echocardiography
  • Electrocardiography
  • Heart Conduction System / physiology*
  • Humans
  • Male
  • Middle Aged
  • Sick Sinus Syndrome / complications*
  • Sick Sinus Syndrome / diagnostic imaging
  • Sick Sinus Syndrome / physiopathology