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Recurrent syncope triggered by inappropriate sinus tachycardia.
Gerold Mönnig1, Michael Ribbing, Kristina Wasmer
1Department of Cardiology and Angiology, University Hospital Münster, Münster, Germany. moennig@uni-muenster.de
Pacing and Clinical Electrophysiology : PACE
|October 6, 2004
Summary
Recurrent syncope in a young woman was linked to inappropriate sinus tachycardia, a fast heart rhythm. Treatment involved pacemaker implantation, resolving the fainting episodes and improving quality of life.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Syncope, or fainting, can be debilitating, significantly impacting daily life and leading to injuries.
- Identifying the underlying cause of syncope is crucial for effective treatment, especially in patients without structural heart disease.
Observation:
- A 25-year-old woman experienced daily syncope and injuries, with electrophysiological studies ruling out structural heart disease.
- Initial electrophysiological study revealed inappropriate sinus tachycardia (IST) with heart rates reaching 190 beats/min, unresponsive to sinus node modulation.
Findings:
- The patient continued to experience syncope during sinus tachycardia (140 beats/min, 60 mmHg systolic blood pressure) post-modulation.
- Successful treatment involved atrioventricular node (AVN) ablation and dual-chamber pacemaker implantation, leading to a 12-month asymptomatic follow-up.
Implications:
- This case highlights inappropriate sinus tachycardia as a potential, previously underrecognized mechanism for recurrent syncope in structurally normal hearts.
- The findings suggest that while IST may not solely cause severe syncope, associated sympathovagal or humoral responses could contribute to syncopal events.