[Syncope due to sinus arrest secondary to marked vagal hypertonus. The role of permanent atrial stimulation in revealing associated atrioventricular node involvement].
The authors report a case of a 42-year-old man, with relapsing syncope, related to sinus arrest, documented by Holter recording. The clinical investigation, the electrophysiological study with autonomic blockade included, have proved normal and then an AAI pacemaker has been implanted. Some weeks later, the patient reported a lipothymic episode; a Holter recording showed a second degree AV block, with normal pacemaker function. A DDD pacemaker has been implanted and in the next ten months the patient felt well. The sinus arrest physiopathology, the role of the autonomic nervous system and the correct electrostimulation mode have been discussed.
Romanò
M
M
Servizio di Cardiologia, Ente Ospedaliero di Garbagnate Milanese (Milano), Regione Lombardia, USSL 67.
Cazzani
E
E
Spinelli
A
A
Muzio
L
L
D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology*; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D006323:Heart Arrest / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012849:Sinoatrial Node / Q000503:physiopathology*; D013575:Syncope / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D014630:Vagus Nerve / Q000503:physiopathology*
Sincope da arresto sinusale secondario a marcato ipertono vagale. Ruolo della stimolazione atriale permanente nello svelare un interessamento associato del nodo atrioventricolare.