John D. Cantwell

Fatal familial cardiac arrhythmias: Histologic observations on the cardiac conduction system☆

Abstract Alternating bidirectional tachycardia leading to death during attempted suppressive therapy was observed in a 16 year old girl without prior clinical evidence of cardiac disease. At autopsy, there was fatty and mononuclear cell infiltration in the atrioventricular conduction system and the main left bundle branch. A similar arrhythmia has been documented in an 18 year old sister who died suddenly 9 months after discovery of her arrhythmia; autopsy revealed no gross cardiac abnormality although the conduction system was not studied. A brother, 21 years old, and the mother of the propositus, aged 45 years, also exhibited ventricular bigeminal rhythm, and a maternal uncle and grandmother had died suddenly, the latter with knowledge of an irregular heart beat. Q-T interval prolongation and auditory defects were not found. Histopathologic changes in the heart and in the conduction system in the propositus support the concept of the origin of the arrhythmia in degenerative change of the conduction system having a genetic base in this kindred.

Cardiologist in the dugout

Abstract “Some baseball is the fate of us all. For my part, I am never more at home in America than at a baseball game.” Robert Frost.