FAMILIAL IDIOPATHIC ATRIAL-FIBRILLATION WITH BRADYARRHYTHMIA

A 10-year-old boy is reported who presented with idiopathic atrial fib rillation and bradyarrhythmia. After history of intrauterine and postn atal bradycardia, atrial fibrillation was first documented electrocard iographically at 16 months of age. An underlying structural heart dise ase was not evident. At the age of 10 years, implantation of a permane nt ventricular demand pacemaker was indicated after syncope due to sev ere bradyarrhythmia. The family history revealed five persons of four generations with bradyarrhythmias. Idiopathic atrial fibrillation know n since childhood was documented in three close relatives. A high grad e AV block resulting in bradyarrhythmias and the occurrence of ST-T-ch anges in precordial leads could be demonstrated in all affected family members suggesting a diffuse,general conduction abnormality in these patients. In this family, idiopathic atrial fibrillation seems to be t ransmitted as an autosomal dominant trait. Conclusion Atrial fibrillat ion without underlying heart disease is extremely rare in children. Ca reful electrocardiographic follow-up of these patients and the evaluat ion of ECG recordings of all family members is recommended.