| Mechanism of syncope in patients with bundle branch block and negative electrophysiological test. | |
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MedLine Citation:
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PMID: 11673344 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In patients with syncope and bundle branch block (BBB), syncope is suspected to be attributable to a paroxysmal atrioventricular (AV) block, but little is known of its mechanism when electrophysiological study is negative. METHODS AND RESULTS: We applied an implantable loop recorder in 52 patients with BBB and negative conventional workup. During a follow-up of 3 to 15 months, syncope recurred in 22 patients (42%), the event being documented in 19 patients after a median of 48 days. The most frequent finding, recorded in 17 patients, was one or more prolonged asystolic pause mainly attributable to AV block; the remaining 2 patients had normal sinus rhythm or sinus tachycardia. The onset of the bradycardic episodes was always sudden but was sometimes preceded by ventricular premature beats. The median duration of the arrhythmic event was 47 seconds. An additional 3 patients developed nonsyncopal persistent III-degree AV block, and 2 patients had presyncope attributable to AV block with asystole. No patients suffered injury attributable to syncopal relapse. CONCLUSIONS: In patients with BBB and negative electrophysiological study, most syncopal recurrences have a homogeneous mechanism that is characterized by prolonged asystolic pauses, mainly attributable to sudden-onset paroxysmal AV block. |
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Authors:
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M Brignole; C Menozzi; A Moya; R Garcia-Civera; L Mont; M Alvarez; F Errazquin; J Beiras; N Bottoni; P Donateo; |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study |
Journal Detail:
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Title: Circulation Volume: 104 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2001 Oct |
Date Detail:
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Created Date: 2001-10-23 Completed Date: 2001-12-04 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2045-50 Citation Subset: AIM; IM |
Affiliation:
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Departments of Cardiology, Ospedali Riuniti, Lavagna, Italy. mbrignole@ASL4.liguria.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block / complications*, physiopathology Defibrillators, Implantable Disease-Free Survival Electrocardiography, Ambulatory* / instrumentation Electrophysiologic Techniques, Cardiac Female Follow-Up Studies Heart Block / complications, diagnosis Heart Conduction System / physiopathology Humans Male Predictive Value of Tests Prospective Studies Syncope / diagnosis*, etiology*, physiopathology Tilt-Table Test |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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