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Pacing may not prevent neurocardiogenic syncope: the importance of correct diagnosis
1Department of Medicine, Veterans General Hospital-Kaohsiung, Taiwan, ROC.
Abstract:
A 28-year-old female with frequent attacks of syncope showed high degree atrioventricular (AV) block in Holter's electrocardiographic monitoring. A permanent pacemaker (VVIR) was implanted. However, the syncope recurred despite the normally-functioning pacemaker. The syncope associated with hypotension and bradycardia was reproduced by upright posture for 8 min. This neurocardiogenic syncope was prevented by propranolol (30 mg/day). Neurocardiogenic syncope should be ruled out before pacemaker implantation in patients with syncope, particularly in young adults with no apparent symptom/electrocardiography correlation.
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