Abstract
Marfan’s syndrome is a common connective tissue disease with different musculoskeletal, ophthalmic and cardiac manifestations. Marfan’s patients carry increased risk for cardiac arrhythmias. Only three cases of atrial flutter in Marfan’s patients are described in the literature. We report a fourth case of a young Marfan’s patient who presents with typical atrial flutter after motor vehicle accident. After electrical cardioversion, sinus rhythm was restored but he had recurrent atrial flutter on follow up. The patient then underwent electrophysiological study and successful radiofrequency catheter ablation of the flutter circuit. Since discharge, the patient has had no documented arrhythmias on follow up.
References
Wilcken, D. E. (2003). Overview of inherited metabolic disorders causing cardiovascular disease. Journal of Inherited Metabolic Disease, 26(2–3), 245–257.
Ramirez, F., Godfrey, M., Lee, B., & Tsipouras, P. (1995). Marfan syndrome and related disorders. In: C. R. Scriver, A. L. Beaudet, W. S. Sly, D. Valle (Eds), The metabolic and molecular basis of inherited disease (7th ed., pp. 4079). McGraw-Hill, New York.
Murdoch, J. L., Walker, B. A, Halpern, B. L, Kuzma, J. W, & Mckusick, V. A. (1972). Life expectancy and causes of death in the Marfan syndrome. New England Journal of Medicine, 286(15), 804–808.
Banerjee, A. K. (1988). Marfan’s syndrome associated with Wolff-Parkinson-White syndrome type B. Japanese Heart Journal, 29(3), 377–380.
Wit, A. L., Fenoglio, J. J. Jr, Wagner, B. M., & Bassett, A. L. (1973). Electrophysiological properties of cardiac muscle in the anterior mitral valve leaflet and the adjacent atrium in the dog. Possible implications for the genesis of atrial dysrhythmias. Circulation Research 32(6), 731–745.
Savolainen, A., Kupari, M., Toivonen, L., Kaitila, I., & Viitasalo, M. (1997). Abnormal ambulatory electrocardiographic findings in patients with the Marfan syndrome. Journal of Internal Medicine, 241(3), 221–226.
Silverman, D. I., Burton, K. J., Gray, J., Bosner, M. S., Kouchoukos, N. T., Roman, M. J., et al. (1995). Life expectancy in the Marfan syndrome. American Journal of Cardiology, 75(2), 157–160.
Finkbohner, R., Johnston, D., Crawford, E. S., Coselli, J., & Milewicz, D. M. (1995). Marfan syndrome. Long-term survival and complications after aortic aneurysm repair. Circulation, 91(3), 728–733.
Savolainen, A., Nisula, L., Keto, P., Hekali, P., Viitasalo, M., Kaitila, I., et al. (1994). Left ventricular function in children with the Marfan syndrome. European Heart Journal, 15(5), 625–630.
Cipolloni, P. B. Jr, Shane, S. R., & Marshall, R. J. (1965). Chronic atrial flutter in brothers with the Marfan syndrome. Circulation, 31, 572–574.
Sahdevan, M. G., Rama, P. T., & Hoon, R. S. (1969). Chronic atrial flutter in a case of Marfan’s syndrome. American Journal of Medicine, 47(6), 965–966.
James, T. N., & Schatz, I. J. (1964). Pathology of cardiac conduction system in Marfan’s syndrome. Archives of Internal Medicine, 114, 339–343.
Frank, R. E. Jr. (1997). Supraventricular tachycardia vs. Marfan’s syndrome. Journal of Insurance Medicine, 29(3), 204–207.
Yetman, A. T., Bornemeier, R. A., & McCrindle, B. W. (2003). Long-term outcome in patients with Marfan syndrome: Is aortic dissection the only cause of sudden death? Journal of the American College of Cardiology, 41(2), 329–332.
Yetman, A. T., Temple, J., & Erickson, C. C. (2002). Radiofrequency ablation of a left-sided atrioventricular pathway in a patient with Marfan syndrome. Cardiology in the Young, 12(5), 494–495.
Shores, J., Berger, K. R., Murphy, E. A., & Pyeritz, R. E. (1994). Progression of aortic dilatation and the benefit of long-term beta-adrenergic blockade in Marfan’s syndrome. New England Journal of Medicine, 330(19), 1335–1341.
Salim, M. A., Alpert, B. S., Ward, J. C., & Pveritz, R. E. (1994). Effect of beta-adrenergic blockade on aortic root rate of dilation in the Marfan syndrome. American Journal of Cardiology, 74(6), 629–633.
Ranade, V., Molnar, J., Khokher, T., Agarwal, A., Mosnaim. A., & Somberg, J. C. (1999). Effect of angiotensin-converting enzyme therapy on QT interval dispersion. American Journal of Therapeutics, 6(5), 257–261.
Calkins, H., Canby, R., Weiss, R., Taylor, G., Wells, P., Chinitz, L., et al. (2004). Results of catheter ablation of typical atrial flutter. The American Journal of Cardiology, 94(4), 437–442.
ACC/AHA guidelines for the management of patient with valvular heart disease. A report of the American College of Cardiology/American Heart Association (Committee on Management of Patients with Valvular Heart Disease). (1998). Journal of the American College of Cardiology, 32, 1486.
Milewicz, D. M., Dietz, H. C., & Miller, D. C. (2005). Treatment of aortic disease in patients with Marfan syndrome. Circulation, 111, e150–e157.
Jeremy, R. W., Huang, H., Hwa, J., Mc Carron, H., Hughes, C. F., & Richards, J. G. (1994). Relation between age, arterial distensibility, and aortic dilatation in the Marfan syndrome. American Journal of Cardiology, 74(4), 369–373.
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Halawa, A., Brahmbhatt, V. & Fahrig, S.A. Initial description of radiofrequency catheter ablation as treatment for atrial flutter in Marfan’s syndrome: A case report and literature review. J Interv Card Electrophysiol 19, 37–40 (2007). https://doi.org/10.1007/s10840-007-9135-8
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DOI: https://doi.org/10.1007/s10840-007-9135-8