Document Detail

Electrophysiologic testing in bundle branch block and unexplained syncope.
MedLine Citation:
PMID:  6475778     Owner:  NLM     Status:  MEDLINE    
Thirty-two patients with bundle branch block and unexplained syncope underwent electrophysiologic testing, including programmed ventricular stimulation with up to triple extrastimuli. The infranodal conduction time (HV) was 70 ms or greater in 12 patients. Pathologic infranodal block during atrial pacing occurred in 2 patients. Unimorphic ventricular tachycardia (VT) was induced in 9 patients (28%) and polymorphic VT in 5 (16%). A permanent pacemaker was implanted in patients with infranodal block during atrial pacing and, generally, in patients with an HV of 70 ms or more. Patients with inducible unimorphic or sustained polymorphic VT were treated with an antiarrhythmic drug. The mean follow-up period was 19 +/- 14 months (+/- standard deviation). Three patients died suddenly: a noncompliant patient with inducible sustained VT; a patient with a normal electrophysiologic study treated empirically with quinidine for premature ventricular complexes; and a patient with an HV of 70 ms and no inducible VT treated with a permanent pacemaker. The actuarial incidence of sudden death was 10% at 45 months of follow-up. Only 2 patients had recurrent syncope; both had a normal electrophysiologic study. Approximately 50% of patients with bundle branch block and unexplained syncope who undergo electrophysiologic testing are found to have a clinically significant abnormality (HV of 70 ms or more, infranodal block during atrial pacing and inducible unimorphic VT), and some patients have more than 1 abnormality. Long-term management guided by the results of electrophysiologic testing generally is successful in preventing recurrent syncope.(ABSTRACT TRUNCATED AT 250 WORDS)
F Morady; J Higgins; R W Peters; A B Schwartz; E N Shen; A Bhandari; M M Scheinman; M J Sauvé
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  54     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1984 Sep 
Date Detail:
Created Date:  1984-09-27     Completed Date:  1984-09-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  587-91     Citation Subset:  AIM; IM    
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MeSH Terms
Bundle-Branch Block / complications,  physiopathology*,  therapy
Cardiac Pacing, Artificial*
Death, Sudden / etiology
Middle Aged
Pacemaker, Artificial
Syncope / etiology*,  physiopathology
Tachycardia / complications,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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