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Ventricular standstill despite normal electrophysiology study: a further possible indication for pacing
Australian and New Zealand Journal of Medicine
|October 1, 1983
Summary
Transient autonomic dysfunction can cause syncope (fainting), even with normal cardiac tests. Permanent pacing effectively treated symptoms in three patients with this condition, suggesting it as a potential cause of unexplained fainting.
Area of Science:
- Cardiology
- Autonomic Nervous System
Background:
- Permanent pacing is typically for sinus node or conduction tissue disease.
- Syncope can stem from various cardiac and neurological causes.
Observation:
- Three patients presented with syncope linked to intense, transient autonomic dysfunction.
- Ventricular standstill was documented, yet electrophysiology studies and autonomic blockade tests were normal.
Findings:
- Normal electrophysiology and autonomic testing do not exclude autonomic dysfunction as a syncope cause.
- Permanent ventricular (VVI) pacing successfully managed syncope in all three patients.
Implications:
- Transient autonomic imbalance should be considered in unexplained cardiac syncope.
- VVI pacing may be a viable treatment for syncope due to autonomic dysfunction.
- Current diagnostic protocols may not fully identify autonomic-related syncope.