[Intrinsic sinus node dysfunction in adolescence during anorexia nervosa].

A seventeen year old girl with anorexia nervosa (32 kg; 165 cm) was admitted as an emergency after syncope with severe bradycardia resistant to atropine monitored over a one week period. Autonomic blockade confirmed the intrinsic character of the sinus node dysfunction with chronotropic incompetence on exercise. Secondarily, a Mobitz I second degree AVB was observed. A DDDR pacemaker was implanted with an excellent functional result. With a one year follow-up, the bradycardia persists but body weight has increased. The authors discuss the physiopathology of this case: in the literature, the classical bradycardia of anorexia nervosa is sensitive to vagolytic drugs and only exceptionally as intense as in this patient. Sinus node dysfunction is very rare in the young in the absence of congenital heart disease. It is possible that the bradycardia had become chronic in this case.