Introduction And Objectives: The objective of this study was to determine the diagnostic yield of a stepped protocol involving an electrophysiologic study (EPS) and implantable loop recorders (ILR) in patients with syncope and bundle branch block (BBB).
Methods: Eighty-five consecutive patients referred for syncope and BBB after initial non-diagnostic assessment underwent EPS including a pharmacological challenge with procainamide. Those patients without indication for defibrillator implantation received ILRs. Follow-up continued until diagnosis or end of battery life.
Results: The EPS was diagnostic in 36 patients (42%). The most frequent diagnoses were paroxysmal atrioventricular block (AVB) (n=27), followed by ventricular tachycardia (VT) (n=6). All patients with VT had structural heart disease; left BBB was more prevalent in this group. Thirty-eight patients received ILRs and diagnosis was achieved in 13 (34%) of them; paroxysmal AVB (n=10) was the most frequent diagnosis. Median follow-up to diagnosis of paroxysmal AVB was 97 days (interquartile range 60-117 days). Paroxysmal AVB was more frequent in patients with right BBB and prolonged PR interval and/or axis deviation. We found no occurrence of VT or arrhythmic death during follow-up.
Conclusions: The most common etiology of syncope in patients with BBB was paroxysmal AVB, followed by VT. The stepped use of EPS and ILR in negative patients enables us to safely achieve a high diagnostic yield, given that VT is usually diagnosed during EPS.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.recesp.2010.10.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Vagal response during radiofrequency catheter ablation initiated from right superior pulmonary vein: Incidence, risk factors, and clinical outcomes.
Int J Cardiol
December 2024
Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address:
Article Synopsis
- The study investigates the vagal response (VR) during pulmonary vein isolation (PVI) for atrial fibrillation (AF), focusing on the incidence, risk factors, and outcomes of VR when initiated from the right superior pulmonary vein (RSPV).
- A total of 702 AF patients were included, with 77 (11.0%) experiencing 81 episodes of VR, primarily in those with paroxysmal AF, and common VR symptoms included sinus arrest and bradycardia.
- Increased body mass index (BMI) and left ventricular ejection fraction (LVEF) were identified as independent risk factors for VR, but the presence of VR did not correlate with improved long-term outcomes in AF recurrence.
Guide Wire Stimulation During Catheter Ablation for Atrial Fibrillation-Induced Cardiac Arrest in a Patient With Preexisting Left Bundle Branch Block: A Case Report.
Cureus
October 2024
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, JPN.
Right bundle branch block can occasionally occur when a guide wire or catheter is inserted into the heart. An 83-year-old woman with preexisting left bundle branch block (LBBB) was diagnosed with paroxysmal atrial fibrillation (PAF) and severe mitral regurgitation (MR). The patient was started on amiodarone (100 mg/day) and bisoprolol (1.
View Article and Find Full Text PDFArrhythmias May Hide a Genetic Cardiomyopathy in Left Ventricular Hypertrabeculation in Children: A Single-Center Experience.
Children (Basel)
October 2024
Pediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital IRCCS, 00050 Rome, Italy.
Article Synopsis
- Left ventricular hypertrabeculation (LVHT) is a heart condition that can lead to various symptoms, including serious issues like heart failure and arrhythmias, making it difficult to identify which cases are benign versus pathological.
- A study analyzed 140 pediatric patients with LVHT over ten years, and found that 23.6% of them experienced arrhythmias, with various types identified, including supraventricular and ventricular arrhythmias.
- Results indicated a significant relationship between specific genetic variants (class 4 or 5) and the occurrence of arrhythmias, while the patients generally had good outcomes, with no reported sudden cardiac deaths.
Clinical Characteristics and Comparative Proteomics Analysis of COVID-19-Related Atrioventricular Block.
Rev Cardiovasc Med
June 2024
State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.
Background: Atrioventricular block (AVB) is thought to be a rare cardiovascular complication of the coronavirus disease 2019 (COVID-19), though limited data are available beyond case reports. We aim to describe the baseline characteristics, proteomics profile, and outcomes for patients with COVID-19-related AVB.
Methods: We prospectively recruited patients diagnosed with COVID-19-related AVB between November 2022 and March, 2023.
Characterization of remodeling processes in the atria of atrioventricular block dogs: Utility as an early-stage atrial fibrillation model.
J Pharmacol Sci
September 2024
Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan; Yamanashi Research Center of Clinical Pharmacology, 73-5 Hatta, Fuefuki, Yamanashi 406-0023, Japan; Organization for the Promotion of Research and Social Collaboration, University of Yamanashi, 4-4-37 Takeda, Kofu, Yamanashi 400-8510, Japan. Electronic address:
To characterize utility of atrioventricular block (AVB) dogs as atrial fibrillation (AF) model, we studied remodeling processes occurring in their atria in acute (<2 weeks) and chronic (>4 weeks) phases. Fifty beagle dogs were used. Holter electrocardiogram demonstrated that paroxysmal AF occurred immediately after the production of AVB, of which duration tended to be prolonged in chronic phase.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!