Coexistence of sick sinus rhythm and atrial flutter-fibrillation

J. A. Gomes, P. S. Kang, M. Matheson, W. B. Gough, N. El-Sherif

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


A 58-year-old man with hypertensive cardiovascular disease and atrial flutter underwent electrophysiologic studies, including multiple intra-atrial recordings and atrial stimulation. Although the surface ECG suggested the presence of atrial flutter, intra-atrial recordings demonstrated the presence of (1) sinus-like rhythm localized to an area of approximately 5 mm in and around the region of the sinus node, which was protected by entrance block; (2) flutter and/or fibrillation of the remaining parts of the right atrium; (3) fibrillation of the left atrium; and (4) transient degeneration of flutter into fibrillation and right atrial sites, with predominant flutter activity. Although a major part of the right atrium was in flutter and/or fibrillation, we could assess sinus node function by overdrive stimulation of the area of sinus node activity. Sinus node function studies revealed an underlying sick sinus syndrome.

Original languageEnglish
Pages (from-to)80-86
Number of pages7
JournalUnknown Journal
Issue number1
StatePublished - 1981
Externally publishedYes


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