[Permanent atrial paralysis].

A case is described of permanent atrial paralysis in a 68 year old female with diabetes and cirrhosis of the liver. Absence of electrical atrial activity was expected on the standard electrocardiogram, and confirmed by intracavitary electrophysiological investigation which showed the ineffectiveness of stimulation of both the right atrium and the coronary sinus. Recording of the His potentials showed that the resultant rhythm was of supra-ventricular origin. The absence of mechanical atrial activity was confirmed radiographically, on the jugular venogram, on the apexogram, and on the tracings of right atrial and pulmonary capillary pressure. A search was made for muscular or neuromuscular dystrophy which has often been found in association with this arrhythmia, but none was found. There may be an etio-pathological relationship between carbohydrate metabolism and atrial paralysis, as certain authors have suggested.