Congenital heart disease with arrhythmia in a family.

Familial occurrence of arrhythmias has been described only rarely in the past. Bacos, Eagan, and Orgain (1960) reported a family group, including three generations, with nodal bradycardia; and Wallgren and Agorio (1960) described congenital complete A-V block in three sibs, two of whom died in the neonatal period. Another group also including three generations, some members of which had congenital heart block, was reported by Gazes et al. (1965). Khorsandian, Moghadam, and Muller (1964) described a family group withA-Vdissociation with occasional ventricular capture, and Wright, Adams, and Anderson (1959) investigated 12 cases with congenital A-V dissociation due either to complete or to advanced A-V block, but none of them had organic congenital heart lesions: two were sibs of a patient with congenital heart block. In their review of the reports of congenital A-V dissociation with congenital heart disease a variety of lesions was recorded, but there were only two with atrial septal defect, one of which also had partial anomalous pulmonary venous drainage. We have investigated a family group of which three members have both hTmodynamic and rhythm disturbances of the same type. The arrhythmia in particular, though a trivial feature of the heart disease, is of interest as it is an unusual one. It consists of intermittent A-V dissociation and first-degree heart block. The family consists of the parents and four children. Of these the mother and two children (aged 4 and 10 years) have been examined and found to be normal. One other child died of bronchopneumonia at the age of 6 months but at necropsy the heart was normal. There is no consanguinity between the parents. This paper is concerned with the father and twin sisters aged 8 years who have congenital heart