Adams-Stokes seizures due to ventricular tachydysrhythmias in patients with heart block: prevalence and problems of management.
One hundred and twelve patients with heart block and chronic tendency to syncope were ECG-monitored during syncope. Ventricular tachycardia and/or fibrillation (VT-VF) was observed as the cause of syncope in 11 patients: in 6 of 20 patients with chronic third degree A-V block, in 3 of 65 with paroxysmal A-V block and in 2 of 27 with S-A block. The R-R interval preceding the escape beat which initiated VT-VF varied between 1.2 and 2.2 seconds. The cerebral attacks were amenable to long-term pacemaker treatment. However, relapses of VT-VF were observed during pacing with a low rate of 55 per minute and during short interruptions in pacing, as produced by intermittent pacemaker failure or threshold determination. In one patient, supplementary treatment with a beta-blocking agent had to be given to suppress exercise-induced attacks of VT-VF after pacemaker implantation.
D000219:Adams-Stokes Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000368:Aged; D003718:Denmark; D005260:Female; D006327:Heart Block / Q000150:complications* / Q000628:therapy; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013575:Syncope / Q000209:etiology / Q000628:therapy; D013610:Tachycardia / Q000150:complications*; D013614:Tachycardia, Paroxysmal / Q000150:complications; D014693:Ventricular Fibrillation / Q000150:complications