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Related Experiment Videos

Reflex cardiac asystole.

M Kofflard, H De Boer, R van Mechelen

    Pacing and Clinical Electrophysiology : PACE
    |November 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    This study details a patient experiencing recurrent syncope with prolonged asystole. Simultaneous sinus and atrioventricular node suppression was observed, offering new insights into this cardiac condition.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Neurology

    Background:

    • Recurrent syncope can stem from various causes, including cardiac arrhythmias.
    • Hypersensitive carotid sinus syndrome (HCSS) can lead to cardioinhibitory syncope with asystole.
    • Understanding the interplay between sinus node and atrioventricular (AV) node suppression is crucial for diagnosing syncope.

    Observation:

    • A patient presented with recurrent syncopal episodes.
    • During an attack, telemetry revealed over 7 seconds of asystole on ECG.
    • This case allowed for the observation of simultaneous sinus and AV node suppression.

    Findings:

    • The patient's asystole demonstrated simultaneous suppression of both sinus and AV nodes.
    • Unlike HCSS, this type of syncope lacks a reproducible induction maneuver for asystole.

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  • Noninvasive and invasive assessments of sinus and AV nodal conduction may be inconclusive in such cases.

    • Implications:

    • This case highlights the simultaneous sinus and AV node suppression mechanism in a specific type of syncope.
    • It suggests limitations of current diagnostic techniques for assessing nodal conduction in these patients.
    • Permanent atrial demand pacing is contraindicated in patients with this observed syncope mechanism.