Familial cardiac laminopathy with predominant atrial involvement: a case series of a family with LMNA mutation.

Abstract

Background: We present a case series detailing a family with familial cardiac laminopathy, including the female index patient, her father, her brother, and her daughter, all diagnosed with atrial arrhythmias, i.e. atrial fibrillation (AF), atrial flutter, and atrial premature contractions.

Case summary: The index patient is known for frequent premature atrial contractions since the age of 35 years and for persistent AF since the age of 46 years. Rhythm control of symptomatic AF was achieved after two ablations. The brother of the index patient is known for asymptomatic persistent AF since the age of 26 years. He has opted for rate control and oral anticoagulation. Their father had persistent AF for many years before his death. The daughter of the index patient has asymptomatic frequent premature atrial contractions. She is under medical surveillance without specific medical treatment. All four patients have a normal ventricular systolic function. Genetic testing revealed a heterozygous missense variant in the LMNA gene causing a familial form of cardiac laminopathy, with clinical predisposition to atrial arrhythmias.

Discussion: The familial occurrence of atrial arrhythmias without significant ventricular involvement in several family members with heterozygous LMNA missense mutation underscores the potential genetic component in cardiac arrhythmias, especially if arrhythmias occur in younger individuals without common risk factors.