Related Experiment Video
Updated: Oct 15, 2025

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
[A patient with second-degree AV block-further work-up and treatment]
Daniel Steven1, Sebastian Dittrich2, Arian Sultan2
1Abteilung für Elektrophysiologie, Herzzentrum der Uniklinik Köln, Kerpenerstraße 62, 59037, Köln, Deutschland. daniel.steven@uk-koeln.de.
Insights
A 64-year-old man experienced palpitations and presyncope despite pacemaker implantation for heart block. Unsuccessful pharmacological treatments prompted further electrophysiological evaluation for suspected tachycardia.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- A 64-year-old male patient presented with intermittent palpitations and presyncope.
- He had a history of dual chamber pacemaker implantation in 2009 for second-degree heart block.
- Previous pharmacological treatments, including beta-blockers, calcium channel antagonists, and ivabradine, were unsuccessful.
Abstract:
We present the case of a 64-year-old man who presented to our outpatient clinic with intermittent palpitations and presyncopal events. In 2009, he underwent dual chamber pacemaker implantation in another institution for 2nd degree heart block. Pharmacological treatment attempts with β‑blocker, calcium channel antagonists and ivabradine remained clinically unsuccessful. Up to this point in time, no documentation of clinical tachycardia, which was reported to result in a heart rate of around 160 beats/minute, was obtained. The patient presented to our clinic for further electrophysiological evaluation.
Related Concept Videos
Dysrhythmias IV: Characteristics of Bradyarrhythmias
Dysrhythmias VI: Management of Dysrhythmias
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Mitral Stenosis II: Clinical features and Diagnostic Tests
Cardiomyopathy II: Dilated Cardiomyopathy
Cardiomyopathy V: Interprofessional Care

