Abstract
A 20-year old man experienced recurrent syncope, that suggested a partially neutrally-mediated mechanism, but in some cases were without a prodrome. The tilt test was negative. The 12-lead ECG and electrophysiological study showed first-degree AV block. Syncope in bradyarrhythmia was suspected and an implantable loop recorder was indicated. In the first month after implantation the patient experienced one syncopal episode. In the stored ECG, AV junctional rhythm was detected. The patient received a pacemaker and symptoms improved.
[1] Brignole M., Alboni P., Benditt D., Bergfeldt L., Blanc J.J., Thomsen P.E., et al., Guidelines on management (diagnosis and treatment) of syncope-update 2004. Executive summary, Eur. Heart J., 2004, 25, 2054–72 Search in Google Scholar
[2] Strickberger S.A., Benson D.W., Biaggioni I., Callans D.J., Cohen M.I., Ellenbogen K.A., et al., AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society, Circulation, 2006, 113, 316–27 http://dx.doi.org/10.1161/CIRCULATIONAHA.105.17027410.1161/CIRCULATIONAHA.105.170274Search in Google Scholar
[3] Assar M., Krahn A., Klein G., Yee R., Skanes A., Optimal duration of monitoring in patients with unexplained syncope. Am. J. Cardiol., 2003, 92, 1231–1233 http://dx.doi.org/10.1016/j.amjcard.2003.07.04210.1016/j.amjcard.2003.07.042Search in Google Scholar
[4] Krahn A., Klein G., Yee R., Hoch J., Skanes A., Cost implications of testing strategy in patients with syncope: randomized assessment of syncope trial, J. Am. Coll. Cardiol., 2003, 42, 495–501 http://dx.doi.org/10.1016/S0735-1097(03)00659-410.1016/S0735-1097(03)00659-4Search in Google Scholar
[5] Sagrista-Sauleda J., Romero-Ferrer B., Moya A., Permanyer-Miralda G., Soler-Soler J., Variations in diagnostic yield of head-up tilt test and electrophysiology in groups of patients with syncope of unknown origin, Eur. Heart J., 2001, 22, 857–865 http://dx.doi.org/10.1053/euhj.2000.239810.1053/euhj.2000.2398Search in Google Scholar PubMed
[6] Fujimura O., Yee R., Klein G., Sharma A., Boahene K, The diagnostic sensitivity of electrophysiologic testing in patients with syncope caused by transient bradycardia, N. Engl. J. Med., 1989, 321, 1703–1707 10.1056/NEJM198912213212503Search in Google Scholar PubMed
[7] Vardas P.E., Auricchio A., Blanc J.J., Daubert J.C., Drexler H., Ector H., et al., Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association, Eur. Heart J., 2007, 28, 2256–2295 http://dx.doi.org/10.1093/eurheartj/ehm30510.1093/eurheartj/ehm305Search in Google Scholar PubMed
© 2008 Versita Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.