Skip to content
BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access October 22, 2008

Young syncopal man and decision about permanent cardiac pacing

  • Malgorzata Lelonek EMAIL logo , Adam Stanczyk and Jan Goch
From the journal Open Medicine


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 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 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 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 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 in Google Scholar PubMed

Published Online: 2008-10-22
Published in Print: 2008-12-1

© 2008 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Downloaded on 31.3.2023 from
Scroll to top button