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Cardiology Research and Practice
Volume 2010, Article ID 383852, 4 pages
http://dx.doi.org/10.4061/2010/383852
Case Report

Myotonic Dystrophy Initially Presenting as Tachycardiomyopathy Successful Catheter Ablation of Atrial Flutter

1II. Medizinische Klinik, Klinikum Coburg, 96450 Coburg, Germany
2Medizinische Universitätsklinik, Innere Medizin III, Abt. für Kardiologie und Angiologie, 79106 Freiburg, Germany
3Klinik für Kinder und Jugendliche, Klinikum Coburg, 96450 Coburg, Germany
4Herz- und Diabeteszentrum Nordrhein-Westfalen, 11 Georgstraße, 32545 Bad Oeynhausen, Germany

Received 23 March 2010; Revised 14 July 2010; Accepted 14 July 2010

Academic Editor: Debabrata P. Mukherjee

Copyright © 2010 S. Asbach et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Myotonic dystrophy is a genetic muscular disease that is frequently associated with cardiac arrhythmias. Bradyarrhythmias, such as sinus bradycardia and atrioventricular block, are more common than tachyarrhythmias. Rarely, previously undiagnosed patients with myotonic dystrophy initially present with a tachyarrhythmia. We describe the case of a 14-year-old boy, who was admitted to the hospital with clinical signs and symptoms of decompensated heart failure and severely reduced left ventricular function. Electrocardiography showed common-type atrial flutter with 2 : 1 conduction resulting in a heart rate of 160 bpm. Initiation of medical therapy for heart failure as well as electrical cardioversion led to a marked clinical improvement. Catheter ablation of atrial flutter was performed to prevent future cardiac decompensations and to prevent development of tachymyopathy. Left ventricular function normalized during followup. Genetic analysis confirmed the clinical suspicion of myotonic dystrophy as known in other family members in this case.