Highlights the genetic etiology of atrial standstill involving SCN5A mutations and emphasizes the clinical necessity of anticoagulation in these patients regardless of standard risk factors.
Suggests anticoagulation in SCN5A atrial standstill despite low risk scores; hypothesis-generating and leaves practice change open.
Key Teaching Points•Atrial standstill with sick sinus syndrome can have a variety of etiologies, which include genetic causes.•Among common mutations are mutations of the SCN5A gene.•Besides treatment of symptomatic bradycardia, anticoagulation is pertinent—even in the absence of other risk factors. •Atrial standstill with sick sinus syndrome can have a variety of etiologies, which include genetic causes.•Among common mutations are mutations of the SCN5A gene.•Besides treatment of symptomatic bradycardia, anticoagulation is pertinent—even in the absence of other risk factors.
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Lehmann et al. (2018) studied this question.
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