Abstract
Our patient was a 55year old male with a family history of Fabry disease and diagnosed with the condition on screening as a teenager demonstrating a low hair follicle fibroblast alpha-galactosidase A activity of 0.06nmol/min/mg (normal range 1.3–7.0nmol/min/mg) and p.R220X mutation. Since the age of 30, he experienced symptomatic paroxysmal atrial fibrillation (AF). He was treated initially with sotalol 80mg twice daily however due to fatigue the dose was reduced to 40mg twice daily. His 12-lead electrocardiogram demonstrated sinus bradycardia of 50–60beatsperminute with a borderline short PR interval, right bundle and left anterior hemiblock with a QRS duration of 200ms.
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