title: [Defecation syncope following pacemaker implantation].
abstract: A case of syncope is reported, where hemodynamic responses compatible with pacemaker syndrome occurred during defecation. A 73 year old female received a VVI pacemaker for complete heart block. Subsequently she sustained repeated episodes of defecation syncope. Hemodynamic investigations revealed an abnormal blood pressure drop occurring at the overshoot phase of the Valsalva maneuver in association with alternation of sinus and pacemaker rhythm. This modified Valsalva response in the presence of contributing factors, such as hypovolemia and nitroglycerin therapy manifested as defecation syncope. The abnormal condition was treated by eliminating the contributing factors, and by programming a low pacemaker frequency, thus precluding sinus-pacemaker alterations.
authors.affiliation: Szent-Györgyi Albert Orvostudományi Egyetem, Szeged.
authors.forename: L
authors.initials: L
authors.lastname: Rudas
authors.forename: A
authors.initials: A
authors.lastname: Kardos
authors.forename: L
authors.initials: L
authors.lastname: Halmai
authors.forename: T
authors.initials: T
authors.lastname: Török
authors.forename: I
authors.initials: I
authors.lastname: Pap
authors.forename: Z
authors.initials: Z
authors.lastname: Hegedüs
mesh_terms: D000368:Aged; D001146:Arrhythmia, Sinus / Q000209:etiology; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects; D003672:Defecation; D005260:Female; D006327:Heart Block / Q000628:therapy*; D006801:Humans; D007022:Hypotension / Q000209:etiology; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013575:Syncope / Q000209:etiology*; D013577:Syndrome; D014636:Valsalva Maneuver
vernacular_title: Defecatiós syncope jelentkezése pacemaker beültetést követóen.