Features suggestive of an isolated increase in vagal tone during electrophysiological study were found in 12 patients with recurrent near syncope or syncope. Results at neurological and cardiac evaluation were otherwise normal. The increased tone or heightened sensitivity to vagal tone was manifested by abnormal atrioventricular nodal refractoriness and conduction that were reversed with atropi...

A previously healthy 4-year-old boy was admitted to hospital for two brief episodes of loss of consciousness. In addition, we note symptoms suggesting a respiratory infection. There was no anemia and no electrolyte imbalance. The child had no neurological symptoms, emergency cerebral CT and EEG were normal. There was however an inappropriate degree of tachycardia, muffled heart sounds and the E...

Abstract The cause of syncope remains unknown in about 40% of cases after extensive investigations. Elderly patients are at increased risk of syncope because of the physiologic changes due to aging, higher incidence of chronic illness and the use of a greater number of medications that may contribute to hypotension. Syncope is common, difficult to evaluate and has a high morbidity and mortality...

BACKGROUND Long QT syndrome (LQTS) is a congenital disorder accompanied by a high incidence of sudden cardiac death. beta-Adrenergic blockade is the therapy of choice, and it is successful in 75-80% of patients. For those in whom cardiac events (syncope or cardiac arrest) are not prevented by beta-blockade, experimental studies suggest that left cardiac sympathetic denervation (LCSD) may be use...

Syncope can be defined as a temporary loss of consciousness and postural tone secondary to a lack of adequate cerebral blood perfusion. The incidence of syncope coming to medical attention appears to be clearly increased in two age groups—that is, in the young and in the old (fig 1). An incidence peak occurs around the age of 15 years, with females having more than twice the incidence of males....

Recognition of cardiac syncope masquerading as epilepsy may be difficult in the Emergency Department. We report a middle-aged man with recent onset convulsions who posed a diagnostic puzzle before it was found that he had paroxysmal ventricular standstill with complete atrioventricular block: he made a complete recovery after temporary pacemaker insertion. The main lessons from this case were (...

There have been few reports on the use of closed loop cardiac pacing in patients suffering from refractory neurocardiogenic syncope. The optimal pacing algorithm using closed loop cardiac pacing has not been well studied. We herein present our single center experience on the specific pacing algorithm, which has been successful in almost 84% of patients.

Recognition of cardiac syncope masquerading as epilepsy may be difficult in the Emergency Department. We report a middle-aged man with recent onset convulsions who posed a diagnostic puzzle before it was found that he had paroxysmal ventricular standstill with complete atrioventricular block: he made a complete recovery after temporary pacemaker insertion. The main lessons from this case were (...

supravalvar mitral ring is a rare congenital heart defect of surgical importance. the condition is characterized by an abnormal ridge of the connective tissue on the atrial side of the mitral valve. it often substantially obstructs the mitral valve inflow. we herein introduce a case of a supravalvar mitral ring in a 17-year-old male, who was admitted to our hospital with cardiac syncope. he had...

Events of ictal bradycardia or asystole may be of relevance in epilepsy patients presenting with ictal falls, and are a potential contributor to SUDEP. The literature on ictal bradycardia or asystole is anecdotal and consists of case reports and small case series. There are no guidelines for the care of patients with ictal arrhythmias. Insertion of cardiac pacemakers may prevent life-threatenin...