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Autonomic and electrocardiographic changes in cardioinhibitory syncope

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Jesper Mehlsen
  • Michelle Nymann Kaijer
  • Anne-Birgitte Mehlsen
Aims Cardioinhibitory syncope (CS) is a neurally mediated response causing bradycardia or asystole. This study reports on changes in blood pressure, heart rate variability (HRV), and ECG patterns before and after syncope with asystole. Methods and results Thirty-five patients with CS and a matched control group were submitted to 60 head-up tilt for 20 min with the addition of nitroglycerin. Syncope developed after a tilt-duration of 1.082 (range 50-1.734 s). Asystole Lasted for 21.3 s (range 3.4-80.2 s) and was preceded by sinus rhythm in 21, junctional rhythm in 10, and atrioventricular block in four. Asystole was followed by sinus rhythm in four, junctional rhythm in 24, atrioventricular block in four, and atria[ fibrillation in three. The two groups did not differ with respect to supine heart rate, HRV or blood pressure. Prior to syncope, patients showed significant increases in total and tow-frequency HRV with reductions in high-frequency HRV and a progressive shortening of the PR-interval. Conclusion Syncope was preceded by marked accentuation of sympathetic tone with a sudden shift in heart rate control to vagal dominance. Asystole was accompanied by vagally induced, benign arrhythmia in the majority of the patients
Udgivelsesdato: 2008/1
OriginalsprogEngelsk
TidsskriftEuropace
Vol/bind10
Udgave nummer1
Sider (fra-til)91-95
Antal sider5
ISSN1099-5129
DOI
StatusUdgivet - 2008

Bibliografisk note

Times Cited: 0ArticleEnglishMehlsen, JUniv Copenhagen, Frederiksberg Hosp, Dept Clin Physiol & Nucl Med, Fasanvej 57, DK-2000 Copenhagen, DenmarkCited References Count: 25264HFOXFORD UNIV PRESSGREAT CLARENDON ST, OXFORD OX2 6DP, ENGLANDOXFORD

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