Abstract
Symptomatic sinus bradycardia, due to either sick sinus syndrome or vagotonia, can be familial, affecting several members of a family. We report an 18-year-old male patient with palpitations and limited exercise capacity who was noted to have severe sinus bradycardia. His resting heart rate was 40/min, with normal PR and corrected QT intervals, and sinus pauses up to 6 seconds during sleep. Exercise treadmill test and pharmacologic autonomic blockade during electrophysiologic studies abolished the bradycardia, suggestive of vagotonia rather than intrinsic sinus node dysfunction. This patient's father and a female cousin had a similar clinical history but associated with syncope and severe sinus bradycardia. The mode of transmission appeared to be autosomal dominant. All three have permanent demand pacemakers implanted and are asymptomatic.
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Mehta, A.V., Chidambaram, B. & Garrett, A. Familial symptomatic sinus bradycardia: Autosomal dominant inheritance. Pediatr Cardiol 16, 231–234 (1995). https://doi.org/10.1007/BF00795713
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DOI: https://doi.org/10.1007/BF00795713