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Content available remote Young syncopal man and decision about permanent cardiac pacing
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nr 4
505-509
EN
A 20-year old man experienced recurrent syncope, that suggested a partially neutrally-mediated mechanism, but in some cases were without a prodrome. The tilt test was negative. The 12-lead ECG and electrophysiological study showed first-degree AV block. Syncope in bradyarrhythmia was suspected and an implantable loop recorder was indicated. In the first month after implantation the patient experienced one syncopal episode. In the stored ECG, AV junctional rhythm was detected. The patient received a pacemaker and symptoms improved.
2
Content available remote Treatment questions in POTS with hypertension and syncope
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nr 3
361-364
EN
A 27-year old man experienced recurrent syncope with prodromal palpitations and resultant injury. The features of these episodes suggested a potentially neurally-mediated mechanism. Head-up tilt test revealed the postural orthostatic tachycardia syndrome (POTS). Within the first minutes of upright posture during the total head-up tilt testing, a heart rate increase of >30 beats/min and to a maximum of 150 beats/min was documented in the patient. At the end of passive tilting, the patient lost consciousness in the absence of hypotension while in sinus rhythm of 140 bpm. The 12-lead ECG and electrophysiological study showed no abnormalities. The patient received a beta-adrenergic blocker, a selective central imidazoline receptor agonist and psychiatric therapy, resulting in only a short-term improvement.
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