Autonomic control of ventilation is impaired in patients with Ondine's curse or congenital central hypoventilation syndrome (CCHS), but voluntary control remains intact. Bradyarrhythmias can be life threatening. In a patient with CCHS and long sinus pause requiring cardiac pacemaker insertion, a diaphragmatic pacemaker inserted in early childhood caused diaphragmatic pacer spikes observed durin...

Among the various rhythms reported in the course of a Stokes-Adams attack, one of the rarest is standstill of the ventricle as an episode during normal rhythm. Such a condition may be called paroxysmal ventricular standstill, and is to be distinguished from the condition of alternating complete block and normal rhythm to which the term paroxysmal heart block may be applied. Three cases of parox...

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 ...

His bundle electrograms were repeatedly recorded in two patients with complex arrhythmias. In the first case the pacemaker was located in the lower part of the left bundle-branch, retrogradely activating the His bundle. Atrial standstill was associated with this mechanism. Afterfour days, His bundle tachycardia occurred, with constant retrograde activation of the atria, and anterograde block. I...

Isolated left ventricular noncompaction (LVNC) is a rare cardiomyopathy with morphologic characteristics of two distinct myocardial layers i.e., thin compacted epicardial and thick noncompacted endocardial layers. The noncompacted myocardium consists of prominent ventricular trabeculae and deep intertrabecular recesses. It can lead to arrhythmias, heart failure or systemic embolisms. Electrocar...

Sinus node dysfunction has been described as an inherited (autosomal recessive form) problem by Benson et al1. The cause seems to be certain specific mutations on the SCN5A gene. Patients with long QT type 3 (SCN5A mutation) have sinus bradycardia as part of the spectrum of abnormalities in this disease2. Atrial standstill is a rare condition where the atrium is silent i.e. there is no electric...