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Proximal coronary sinus pacing induced prolonged asystole.
Shabnam Madadi1, Javad Shahabi2, Mahdi Moeini3
1Associate Professor, Department of Cardiac Electrophysiology AND Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
ARYA Atherosclerosis
|June 10, 2022
Summary
This study reports a rare case of prolonged ventricular asystole induced by coronary sinus pacing. This finding highlights the potential for unexpected cardiac events during electrophysiological studies, emphasizing the need for careful patient monitoring.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Anatomy
Background:
- The atrioventricular node (AVN) regulates atrial to ventricular impulse transmission.
- Vagally mediated AVN block via high-frequency stimulation is documented, but prolonged asystole from low-frequency coronary sinus pacing is rare.
Observation:
- A 40-year-old male presented with syncope and palpitations.
- Electrophysiological study revealed prolonged ventricular asystole during proximal CS overdrive pacing.
Findings:
- Proximal CS pacing can induce significant vagally mediated atrioventricular block (AVB).
- This case highlights an unusual presentation of AVB.
Implications:
- Further research is needed to understand the link between vasovagal syncope and posteroseptal stimulation-induced AVB.
- Radiofrequency catheter ablation of ganglionated plexi (GP) shows promise for treating vasovagal syncope by modulating vagal efferent activity.
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