Syncope as a clinical manifestation of paroxysmal atrioventricular block and response to bicameral pacemaker implantation
DOI:
https://doi.org/10.21615/cesmedicina.5672Keywords:
Atrioventricular block, Syncope, Electrocardiography, PacemakerAbstract
Syncope is the main symptom presented by patients with paroxysmal complete atrioventricular block, and it may be due to several intrinsic or extrinsic etiologies. AV blocks are a major cause of dysfunction, with a high burden of disease, even in patients without ischemic heart disease or underlying structural abnormality. The case of a patient with a structurally normal heart is presented, who was admitted for a syncope study and during a 24-hour Holter monitoring, a paroxysmal complete AV block was documented, which led to the implantation of a bicameral pacemaker and had a very good response to the procedure. Complete AV blocks can be paroxysmal or permanent, and the only way to differentiate them is by electrocardiographic findings. It is very important to make the diagnosis of complete AV block, either paroxysmal or permanent because the only treatment is the implantation of a cardiovascular implantable electronic device.
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Shen Win-Kuang, Sheldon Robert S., Benditt David G., Cohen Mitchell I., Forman Daniel E., Goldberger Zachary D., et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136 (5):e60–122.
Brignole M, Moya A, De Lange FJ, Deharo JC, Elliott PM, Fanciulli A, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. European Heart Journal 2018;39, 1883–1948.
Blanc J-J. Syncope: Definition, Epidemiology, and Classification. Cardiol Clin. 2015 ;33 (3):341–5.
Runser LA, Gauer RL, Houser A. Syncope: Evaluation and Differential Diagnosis. Am Fam Physician. 2017;95 (5):303–12.
Martow E, Sandhu R. When Is Syncope Arrhythmic? Med Clin North Am. 2019103 (5):793–807.
Thiruganasambandamoorthy V, Hess EP, Turko E, Tran M-L, Wells GA, Stiell IG. Defining abnormal electrocardiography in adult emergency department syncope patients: the Ottawa Electrocardiographic Criteria. Can J Emerg Med. 2012;14 (4):252–62.
Lee S, Wellens HJJ, Josephson ME. Paroxysmal atrioventricular block. Heart Rhythm. 2009;6 (8):1229–34.
Alboni P, Holz A, Brignole M. Vagally mediated atrioventricular block: pathophysiology and diagnosis. Heart Br Card Soc. 2013;99 (13):904–8.
Brignole M, Deharo J-C, De Roy L, Menozzi C, Blommaert D, Dabiri L, et al. Syncope due to idiopathic paroxysmal atrioventricular block: long-term follow-up of a distinct form of atrioventricular block. J Am Coll Cardiol. 2011;58 (2):167–73.
Bansal R, Mahajan A, Rathi C, Mehta A, Lokhandwala Y. What is the mechanism of paroxysmal atrioventricular block in a patient with recurrent syncope? J Arrhythmia. 2019;35 (6):870–2.
Menon SMD, Ribas CS, Meneclier CAR, Morillo CA. Intermittent atrioventricular block: What is the mechanism? Heart Rhythm. 2012;9 (1):154–5.
Brignole M, Gaggioli G, Menozzi C, Gianfranchi L, Bartoletti A, Bottoni N, et al. Adenosine-induced atrioventricular block in patients with unexplained syncope: the diagnostic value of ATP testing. Circulation. 1997;96 (11):3921–7.
Cai SY, Ye SF, Wu X, Xiang MX, Wang JA. Torsade de pointes in a patient with complete atrioventricular block and pacemaker failure, misdiagnosed with epilepsy. J Electrocardiol. 2015; 48(3):450-454.
Sachs A, Traynor RL. Paroxysmal complete auriculo-ventricular heart-block: A case report. Am Heart J. 1933 1;9 (2):267–71.
Coumel P, Fabiato A, Waynberger M, Motte G, Slama R, Bouvrain Y. Bradycardia-dependent atrio-ventricular block: Report of two cases of A-V block elicited by premature beats. J Electrocardiol. 1971;4 (2):168–77.
Brignole M, Deharo J-C, Guieu R. Syncope and Idiopathic (Paroxysmal) AV Block. Cardiol
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