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Syncope and aortic stenosis: significance of conduction abnormalities
European Journal of Cardiology
|May 1, 1979
Summary
Syncope in patients with aortic stenosis may stem from heart conduction issues. Aortic valve replacement successfully treated syncope, even in those with prolonged His-ventricle (HV) intervals.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Syncope is a common symptom in patients with significant aortic stenosis.
- The underlying mechanism of syncope in this population is not fully understood.
- Electrophysiological abnormalities may contribute to syncope in aortic stenosis.
Purpose of the Study:
- To investigate the prevalence and significance of electrophysiological abnormalities in patients with syncope and aortic stenosis.
- To determine the correlation between hemodynamic parameters and electrophysiological findings.
- To assess the efficacy of aortic valve replacement in resolving syncope in these patients.
Main Methods:
- Twenty-two patients with syncope and severe aortic stenosis underwent electrophysiological evaluation.
- Hemodynamic studies were performed concurrently.
- His-ventricle (HV) intervals were measured to assess conduction abnormalities.
Main Results:
- Electrophysiological abnormalities were identified in 12 out of 22 patients.
- Six patients had prolonged HV intervals (≥55 msec).
- No significant correlation was found between aortic valve gradient, ventricular end-diastolic volume, aortic valve calcification, and HV interval duration.
Conclusions:
- Electrophysiological abnormalities are common in patients with syncope and aortic stenosis.
- Aortic valve replacement effectively resolves syncope, irrespective of the presence of prolonged HV intervals.
- These findings suggest that syncope in this cohort is primarily related to the aortic stenosis itself, rather than isolated conduction defects.