THE pathogenesis of atrial fibrillation remains obscure. Animal experiments and clinical pathologic studies have failed to demonstrate a single morphologic lesion as the basis of this physiological abnormality. The following case is one in which long standing atrial fibrillation was associated with occlusion of the sinus node artery. To our knowledge a similar case has not been reported.
Report of a Case
A 37-year-old male accountant was admitted to the Salt Lake County General Hospital on Sept 21, 1961, for evaluation of atrial fibrillation. No definite history of rheumatic fever was elicited although a two-week febrile illness at age 9 had been undiagnosed. At age 19, because of an irregular pulse of several years' duration, an electrocardiogram was obtained which demonstrated a nodal rhythm with frequent premature beats of atrial origin (Fig 1). The following year he was rejected for military service because of an irregular heart rate and at