Deficiency of the mitochondrial inorganic pyrophosphatase 2 (PPA2) protein resulting from biallelic genetic variants reducing enzyme activity has been identified as a rare cause of sudden cardiac death in young children and teenagers, often associated with preceding viral infection or alcohol consumption. As the field of cardiac genetics continues to evolve, the PPA2 gene is now included on many, but not all, commercially available arrhythmia and cardiomyopathy panels. As a result, a total of 65 patients with PPA2 deficiency have been reported in the literature over the past eight years, with 11 known survivors.

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart defect characterized by at least one pulmonary vein draining into the systemic venous system.1 It occurs in only 0.3% of adults, and most patients with PAPVR are asymptomatic, often diagnosed incidentally through various imaging evaluations.2

The incidence of isolated PR prolongation post-Trans-Aortic Valve Replacement (TAVR) is up to 13%, and is considered to have a benign prognosis.1 The incidence of new onset arrhythmias post-TAVR is reported at 31%,2 the majority being atrial fibrillation (19%). Only 10% and 2% are noted to be ventricular tachycardia (VT) or supraventricular tachycardia (SVT), respectively.2