case_images: PMC10758468_01
case_images: Short-axis cardiac magnetic resonance images demonstrating normal biventricular size and no evidence of late gadolinium enhancement.
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case_images: PMC10758468_01_fcvm-10-1328898-g001.jpg
case_images: F1
case_images: ACM after a resuscitated cardiac arrest. At the time, the patient underwent comprehensive workup including electrocardiogram, echocardiogram, and cMRI which were normal (Figure 1); no evidence of ACM or arrhythmias was found.
case_images: (A) Event monitor demonstrating sinus pause of 3.7 s; (B) presenting 12-lead electrocardiogram.
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case_images: PMC10758468_01_fcvm-10-1328898-g002.jpg
case_images: F2
case_images: The event monitor showed several nocturnal pauses up to 3.7 s in duration (Figure 2A) without corresponding symptoms. His electrocardiogram (Figure 2B) showed sinus rhythm with first degree atrioventricular block (PR interval 230 ms).
case_images: Representative telemetry tracings demonstrating sinus arrest episode while in the hospital. (A) Sinus rhythm with rate slowing in the middle of the tracing. (B) Sinus bradycardia with further slowing of sinus rate. (C) Marked sinus bradycardia before frank sinus arrest.
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case_images: PMC10758468_01_fcvm-10-1328898-g003.jpg
case_images: F3
case_images: Shortly afterwards, he had several episodes of marked sinus rate slowing followed by overt sinus arrest up to 8 seconds in duration (Figure 3).
case_images: Representative tracings recorded at pacemaker implant. (A) Intrinsic sinus rhythm, P wave measuring 158 ms. (B) Atrial pacing at 500 ms, P wave measuring 168 ms.
case_images: fcvm-10-1328898-g004.jpg
case_images: PMC10758468_01_fcvm-10-1328898-g004.jpg
case_images: F4
case_images: Atrial pacing with the lead positioned in the right atrial appendage demonstrated fragmented, low-amplitude and prolonged paced P wave suggestive of significant intra-atrial conduction delay and atriopathy (Figure 4).