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Time relation between a syncopal event and documentation of atrioventricular block in patients with bifascicular block: clinical implications
Örebro University, School of Health and Medical Sciences.
2007 (English)In: Cardiology, ISSN 0008-6312, E-ISSN 1421-9751, Vol. 108, no 2, 138-143 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Transient high-degree atrioventricular (AV) block is a common cause of syncope in patients with bifascicular block (BFB) but the intermittent nature of AV block makes ECG documentation a challenge. A sensitive and safe tool to investigate BFB patients with syncope would be a bradycardia-detecting pacemaker, which provides a possibility of studying the time relation between the index syncopal episode and the development of high-degree AV block. METHODS: Twenty-seven patients with BFB and syncope were studied prospectively. All patients received a single-chamber ventricular-based pacemaker with bradycardia-detecting ability. A bradycardia episode was defined as a heart rate of < 30 beats/min lasting > or = 6 s. RESULTS: During a median follow-up of 60 months, a bradycardia event was detected in 14 patients (52%), of whom 13 also had documented high-degree AV block on ECG. The median time between the syncopal episode and the first pacemaker-detected bradycardia event was 5 months and after an additional median time of 6 months, high-degree AV block was documented on the ECG. In 10 of 13 patients (77%) high-degree AV block was documented within 24 months of the syncopal episode corresponding to an annual incidence of 19% during the first 2 years of follow-up in the study population. CONCLUSION: In this group of BFB patients a syncopal episode was highly predictive of the development of high-degree AV block within 24 months, justifying pacemaker therapy without prior ECG verification.

Place, publisher, year, edition, pages
Basel: Karger , 2007. Vol. 108, no 2, 138-143 p.
National Category
Medical and Health Sciences Cardiac and Cardiovascular Systems
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-11600DOI: 10.1159/000096038PubMedID: 17028424OAI: oai:DiVA.org:oru-11600DiVA: diva2:344137
Available from: 2010-08-17 Created: 2010-08-17 Last updated: 2017-12-12Bibliographically approved

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Englund, Anders

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