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[Basic diagnostic program in dizziness and syncope symptoms: value of electrophysiologic studies of the heart]
W Kettner1, U Schröter, S Reinhold
1Kardiologischen Abteilung, Bezirkskrankenhauses Magdeburg.
Insights
Cardiovascular diseases are often the cause of syncopes and giddiness. Invasive electrophysiologic investigations precisely diagnosed sick sinus syndrome, AV-sequences, and ventricular arrhythmias in two-thirds of patients.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Context:
- Syncope and giddiness evaluations involve multiple medical specialties.
- Cardiovascular causes must be ruled out, necessitating specific diagnostic pathways.
- Invasive investigations are considered when non-invasive methods are insufficient or inconclusive.
Purpose:
- To evaluate the diagnostic yield of invasive electrophysiologic investigations in patients with syncope and related symptoms.
- To identify the primary cardiac arrhythmias contributing to syncopal events.
Summary:
- Electrophysiologic investigation, including sinus node testing and programmed ventricular stimulation, was performed on 45 patients.
- In two-thirds of cases, this invasive approach refined or established diagnoses.
- Key findings included sick sinus syndrome, atrioventricular (AV) conduction abnormalities, and ventricular arrhythmias.
Impact:
- Invasive electrophysiology significantly enhances diagnostic accuracy for complex syncope.
- Identifies specific arrhythmias, guiding targeted therapeutic strategies.
- Improves patient outcomes by clarifying the etiology of syncopal episodes.
Abstract:
Syncopes and preceding signs and symptoms, particularly also in form of appearances of giddiness, are, including specialists of various branches, among others ENT, neurology, orthopaedics and ophthalmology, always to be classified according to the fact whether or not a cardiovascular disease is to be regarded as cause. If there is the suspicion, both special non-invasive investigations and such ones which possibly are to be performed invasively are indicated. The latter come after the non-invasive investigations partly on account of the expenditure (technique of heart catheterization) and the possibilities of complication. The testing of the sinus node with the highly frequent atrial stimulation and single stimulus technique, the lead of the His-potential and the performance of a ventricular programmed stimulation are the fundamental programmes of an electrophysiologic investigation. In an analysis carried out more than 3 years could be found that in two thirds of the 45 invasively examined patients the diagnosis could be precised and enhanced, respectively, and that the main disturbances related to the signs and symptoms were a sick sinus syndrome, AV-asequences and ventricular arrhythmias.