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Published on: July 3, 2013
Intrahissian anisotropy and second degree type I block
Jeffrey L Williams1, David Lugg, Robert Gray
1Good Samaritan Health System, Lebanon Cardiology Associates, 775 Norman Drive, Lebanon, PA 17042.
This study reports a rare case of a patient experiencing both intrahissian Wenckebach and anisotropy, leading to syncope. A dual-chamber pacemaker successfully treated these cardiac conduction abnormalities.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Syncope can result from various cardiac conduction abnormalities.
- Intrahissian Wenckebach and anisotropy are distinct electrophysiological phenomena affecting cardiac conduction.
Purpose of the Study:
- To report the first documented case of co-occurring intrahissian Wenckebach and anisotropy in a single patient presenting with syncope.
- To highlight the diagnostic and therapeutic approach for complex conduction disorders.
Main Methods:
- Invasive electrophysiologic study was performed to evaluate the cause of syncope.
- Diagnostic criteria for intrahissian Wenckebach and anisotropy were applied.
- Dual-chamber pacemaker implantation was performed.
Main Results:
- Electrophysiologic evaluation confirmed the presence of both intrahissian Wenckebach and anisotropy in the patient.
- The patient experienced multiple episodes of witnessed syncope attributed to these conduction abnormalities.
- Dual-chamber pacemaker implantation was technically successful and without immediate complications.
Conclusions:
- The simultaneous occurrence of intrahissian Wenckebach and anisotropy is a rare but significant finding in patients with syncope.
- Electrophysiologic studies are crucial for diagnosing complex conduction disturbances.
- Pacemaker implantation is an effective treatment for syncope caused by these conditions.
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