title: Neurally mediated syncope manifesting during atrial fibrillation: a case report.
abstract: A 64-year-old male was admitted to hospital because of repeated episodes of syncope and palpitation. Ambulatory monitoring revealed paroxysmal atrial fibrillation (AF) as the cause of palpitation; he did not have structural heart disease. The induction of AF by rapid pacing (50 Hz for 1 s) in an upright position provoked syncope with a vasodepressor response. Atropine sulfate blocked the induction of syncope. The possible etiology was neurally mediated syncope that manifested only during AF, which suggests that the abnormal vagal activity during AF in this case exaggerated the vasodepessor response while upright.
authors.affiliation: Kyoto Prefectural University of Medicine, Second Department of Medicine, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.forename: Keiji
authors.initials: K
authors.lastname: Inoue
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Midori
authors.initials: M
authors.lastname: Yamamura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mani
authors.forename: Akiko
authors.initials: A
authors.lastname: Yoshida
authors.forename: Hiroto
authors.initials: H
authors.lastname: Imai
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Matoba
authors.forename: Masao
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D019462:Syncope, Vasovagal / Q000209:etiology*; D018667:Tilt-Table Test; D014630:Vagus Nerve / Q000503:physiopathology