Key result
Cardiac oxalate infiltration linked to severe AV dissociation in primary oxalosis.
Why the study?
Cardiac electrophysiologic abnormalities due to oxalate infiltration in primary oxalosis had not been previously reported.
Case Report (n=1)
This is the first reported case demonstrating that cardiac electrophysiologic abnormalities in primary oxalosis are directly correlated with oxalate infiltration of the conduction system.
Oxalate infiltration may underlie conduction disease in primary oxalosis; first case report extends mechanistic insight but leaves open clinical implications.
A 27-year-old man with primary oxalosis and extensive visceral involvement was maintained on long-term chronic hemodialysis. He had an episode of presyncope associated with electrocardiographic findings of an erratic atrial rhythm, atrioventricular dissociation due to an accelerated junctional rhythm and right bundle branch block. Electrophysiologic studies showed irregular atrial depolarizations probably associated with multiple atrial pacemakers, atrial inexcitability, atrioventricular dissociation and infranodal conduction delay. These findings correlated well with extensive oxalate infiltration of the sinoatrial node and its approaches, the atrial preferential pathways, the approaches to the atrioventricular node, the atrioventricular node, and the His bundle and bundle branches. This is the first reported case of cardiac electrophysiologic abnormalities due to oxalate infiltration in a patient with primary oxalosis.
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Massie et al. (1981) conducted a case report in Primary oxalosis with pan-conduction cardiac disease (n=1). Oxalate infiltration was evaluated on Electrophysiologic abnormalities. Extensive oxalate infiltration of the cardiac conduction system in a patient with primary oxalosis caused severe electrophysiologic abnormalities including atrioventricular dissociation.
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