title: Appropriate management of syncope in a patient with hypertrophic cardiomyopathy: rationale behind long-term cardiac rhythm monitoring.
abstract: We describe the case of a patient with hypertrophic cardiomyopathy who had recurrent syncopal episodes, the cause of which remained unexplained despite a thorough evaluation. Two years after his first evaluation, an implantable loop recorder revealed asymptomatic episodes of advanced second degree atrioventricular block while the patient was awake. Although a permanent pacemaker was implanted, the patient continued to suffer syncopal episodes, during which the pacemaker recorded episodes of ventricular tachycardia. Accordingly, the device was upgraded to an implantable cardioverter-defibrillator.
authors.affiliation: Cardiology Department, Heraklion University Hospital, Crete, Greece.
authors.forename: Eva G
authors.initials: EG
authors.lastname: Arkolaki
authors.forename: Emmanuel N
authors.initials: EN
authors.lastname: Simantirakis
authors.forename: Stavros I
authors.initials: SI
authors.lastname: Chrysostomakis
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas