title: All that glitters is not gold ... all that faints is not slow.
abstract: An 82 year old man presented with multiple syncopal episodes. Since his ECG showed LBBB (left bundle branch block) with first degree AV block, he was advised permanent pacemaker implantation. However, a wide QRS tachycardia on the Holter raised the possibility of tachycardia-mediated syncope. EP (electrophysiological) studies revealed easily and repeatedly inducible short lasting slow-fast AVNRT (atrioventricular nodal reentry tachycardia) with severe hypotension. After RF ablation of the slow pathway, he is asymptomatic at six month follow-up.
authors.affiliation: Cardiology, Quintiles ECG Services, Mumbai.
authors.forename: S C
authors.initials: SC
authors.lastname: Toal
authors.forename: A
authors.initials: A
authors.lastname: Palshikar
authors.forename: M
authors.initials: M
authors.lastname: Khan
authors.forename: Y
authors.initials: Y
authors.lastname: Lokhandwala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D013575:Syncope / Q000175:diagnosis*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000628:therapy