A Different Breed of Wolf: First Known Case of Wolf-Hirschorn Syndrome with Third-degree Atrioventricular Block Requiring Pacemaker Implantation.

We describe a case of a 44-year-old male with a history of Wolf-Hirschorn syndrome (WHS) with seizures and mental retardation who was evaluated for what was thought to be a seizure. He was found to be severely bradycardic with a heart rate of 24 bpm. The electrocardiogram revealed third-degree atrioventricular block and he subsequently underwent an uncomplicated single-chamber pacemaker implantation procedure. This is a unique report given its status as the first described case of bradycardic rhythm abnormalities in a patient with WHS.

SANS FLUORO Supersized: A case report of Fluoroless Ablation in a Super Morbidly Obese Patient.

We present the first ever reported case of a super morbidly obese patient (BMI > 70) with drug refractory, symptomatic atrial flutter who underwent a successful, uncomplicated ablation procedure using a zero fluoroscopy technique. This case demonstrates the following two critical points: (1) difficulties in the treatment of massively obese patients with arrhythmias; (2) increased use of fluoroless ablation techniques.

Atrial myxoma: case report and a review of the literature.

Atrial myxomas are the most common benign primary tumor of the heart and occur in as many as 3 in 1000 patients. These tumors are a major cause of patient morbidity and mortality. Although the majority of atrial myxomas occur in the left atrium, 3 separate familial myxoma syndromes can result in multiple myxomas in atypical locations. Approximately 50% of patients with myxomas may experience symptoms due to central or peripheral embolism or intracardiac obstruction, but 10% of patients may be completely asymptomatic. Screening for myxomas should involve a thorough history and physical examination and a transthoracic and/or transesophageal echocardiogram. Transthoracic echocardiography is approximately 95% sensitive for the detection of cardiac myxomas, and transesophageal echocardiography approaches 100% sensitivity. Though the majority of atrial myxomas are sporadic, it is imperative that first-degree relatives of patients with documented myxomas undergo screening for occult myxomas. Surgical removal of the myxoma is the treatment of choice and usually curative; however, myxoma recurrence does occur and is most frequently associated with a familial syndrome.