title: Disopyramide for transient high-degree atrioventricular block in a young patient with a history of syncope.
abstract: Although high-degree atrioventricular (AV) block in patients with a history of syncope usually requires pacemaker implantation, therapeutic strategies should also be considered. A 35-year-old man presented with complaints of palpitations, nausea and dysgeusia. Since aged 30, the patient had experienced three episodes of syncope. Holter monitoring showed transient high-degree AV block (up to 5:4 block) associated with nausea, eructation and dysgeusia irrelevant to posture as well as ventricular ectopic beats with palpitation. A head-up tilt test revealed neurally mediated vasodepression but electrophysiological study showed no abnormalities. These results indicated that his transient high-degree AV block was functional, and syncope would have been because of neurally mediated vasodepression, not bradycardia. After administration of disopyramide at 300 mg daily, the symptoms subsided and ventricular ectopic beats and AV block disappeared. He has been well for 20 months.
authors.affiliation: Department of Molecular and Internal Medicine, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. sesekys@hotmail.com
authors.forename: Yukoh
authors.initials: Y
authors.lastname: Hirai
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogi
authors.forename: Shinji
authors.initials: S
authors.lastname: Kajiwara
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D054537:Atrioventricular Block / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004206:Disopyramide / Q000627:therapeutic use*; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008297:Male; D013575:Syncope / Q000150:complications*; D018667:Tilt-Table Test
chemical_list: D000889:Anti-Arrhythmia Agents; D004206:Disopyramide