Cor Vasa 2009, 51(4):285-289 | DOI: 10.33678/cor.2009.070

The case report of a patient with sinus arrest

Andrej Myjavec*, Jiří Kvasnička, Aleš Havlíček, Petr Vojtíšek
Kardiologické oddělení Interní kliniky, Pardubická krajská nemocnice a. s., Pardubice, Česká republika

A challenging area of differential diagnosis in consciousness disorders due to short-term circulatory arrest (syncope) are acute neurological syndromes mimicking syncope. The most common of these syndromes is epilepsy. In about 10% of patients diagnosed to have and treated for epilepsy (mostly those experiencing seizures as the dominant symptom), the underlying cause of a consciousness disorder is short-term circulatory arrest. We report the observation of a patient assessed for recurrent consciousness disorders whose clinical picture of disorders made us consider mainly a neurological cause. The diagnosis - an unusual form of sinus arrest - could only be established by examining the patient with an implantable ECG recorder ("Reveal" Medtronic) using a memory loop.

Keywords: Syncope; Sinus arrest; Implantable ECG recorder

Published: April 1, 2009  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Myjavec A, Kvasnička J, Havlíček A, Vojtíšek P. The case report of a patient with sinus arrest. Cor Vasa. 2009;51(4):285-289. doi: 10.33678/cor.2009.070.
Download citation

References

  1. Shah J, Zhai H, Fuerst D, Watson C. Hypersalivation in Temporal Lobe Epilepsy. Epilepsia 2006;47:644-51. Go to original source... Go to PubMed...
  2. Smith D, Defalla BA, Chadwick DW. The misdiagnosis of epilepsy and the management of refractory epilepsy in a specialist clinic. Q J Med 1999; 92:15-23. Go to original source...
  3. Kanner MA. Common errors made in the diagnosis and treatment of epilepsy. Sem Neurol 2008;28:364-78. Go to original source... Go to PubMed...
  4. Pérez A, Medrano V, Martínez-Menéndez B, Mas F. A descriptive analysis of 81 patients referred to a neurology clinic for syncope. Rev Neurol 2001; 33:315-8. Go to original source... Go to PubMed...
  5. Lombardi F, Caloss E, Mascioli G, et al. Utility of implantable loop recorder (Reveal Plus®) in the diagnosis of unexplained syncope. Europace 2005; 7:19-24. Go to original source... Go to PubMed...
  6. Lempert F. Convulsive syncope: www.medlink.com/medlinkcontent.asp
  7. Sheldon R, Rose S, Ritchie D, et al. Historical criteria that distinguish syncope from seizures. J Am Coll Cardiol 2002;40:142-8. Go to original source...
  8. Lhatoo DS, Sander JW, Tomson T. Chapter 10. Mortality. In: Engel J Jr, Pedley TA, Aicardi J, et al. Epilepsy. A comprehensive textbook. 2nd ed. Philadelphia: Lippincott Williams and Wilkins, A Wolters Kluwer Business, 2008:2979.
  9. Rocamora R, Kurthen M, Lickfett L, Oertzen J von, Elger CE. Cardiac asystole in epilepsy: Clinical and Neurophysiological Features. Epilepsia 2003;44:179-85. Go to original source...
  10. Maggi R, Menozzi C, Brignole M, et al. Cardioinhibitory carotid sinus hypersensitivity predicts an asystolic mechanism of spontaneous neurally mediated syncope. Europace 2007;9:563-7. Go to original source... Go to PubMed...
  11. Krahn AD, Klein GJ, Yee R, Norris C. Final results from a pilot study with implantable loop recorder to determine the etiology of syncope in patients with negative noninvasive and invasive testing. Am J Cardiol 1998;82:117-9. Go to original source...
  12. Brignole M, Sutton R, Menozzi C, et al. Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope. Eur Heart J 2006;27:1085-92. Go to original source... Go to PubMed...
  13. Cock CC. The implantable loop recorder: A tool that is "here to stay". Indian Pacing Journal 2002;2:15-9.
  14. Sinus arrest and sinoatrial exit block. In: Sinus Disturbances. www.americanheart.org/presenter.jhtml?identifier=55
  15. Olgin JE, Zipes DP. Specific Arrhytmias: Diagnosis and Treatment. In: Braunwald E, Zipes DP, Libby P, et al. Braunwald's Heart Disease. A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia: Elsevier Inc., 2005:2183.
  16. Bharati S, Goldschlager N, Kusumoto F, et al. Sinus Node Dysfunction. In: Saksena S, Camm AJ, Boyden PA, et al. Electrophysiological Disorders of the Heart. 1st ed. Philadelphia: Elsevier Inc., 2005:1035. Go to original source...
  17. Rokseth R, Hatle L. Sinus arrest in acute myocardial infarction. Br Heart J 1971;33:639-42. Go to original source... Go to PubMed...
  18. Namura M, Kanaya H, Ikeda M, Shibayama S, Ohka T. Hyperthyroidism complicated with sick sinus syndrome. Jpn Circ J 1995;59:824-8. Go to original source... Go to PubMed...
  19. Nakagawa S, Higa A, Kondoh H, Koiwaya Y, Tanaka K. Cyclic sinus node dysfunction in a patient with hyperthyroidism. Arch Inter Med 1985;145: 2126-7. Go to original source...
  20. Bruch C, Dagres N, Wieneke H, Herborn C, Brandt-Mainz K, Erbel R. Sinus node dysfunction with intermittent sinus arrest and AV-nodal escape rhythm as initial manifestation of pheochromocytoma. Z Kardiol 2002;91:81-7. Go to original source...
  21. Zubkova ST, Shliakhtich SL, Lisianskaia SM, Kuz'minskaia LA. Cardiovascular disorders in patients with pheochromocytoma. Lik Sprava 2003;3-4: 25-8.
  22. Becker H, Brandenburg U, Peter JH, Wichert P. Reversal of sinus arrest and atrioventricular conduction block in patients with sleep apnea during nasal continuous positive airway pressure. Am J Respir Crit Care Med 1995;151: 215-8. Go to original source... Go to PubMed...
  23. Coccagna G, Capucci A, Pierpaoli S. A case of sinus arrest and vagal overactivity during REM sleep. Clin Auton Res 1999;9:135-8. Go to original source...
  24. Guilleminault C, Pool P, Motta J, Gillis AM. Sinus arrest during REM sleep in young adults. N Engl J Med 1984;311:1006-10. Go to original source... Go to PubMed...
  25. Robinson SD, Murray S. Prolonged sinus arrest in an asymptomatic woman. Emerg Med J 2007;24:613. Go to original source... Go to PubMed...
  26. Ha JW, Cho SY. Prolonged sinus arrest after coronary artery spasm. Heart 2003;89:558. Go to original source...
  27. Choi YS, Kim JJ, Oh BH, Park YB, Seo J, Lee YW. Cough syncope caused by sinus arrest in a patient with sick sinus syndrome pacing and clinical electrophysiology. Pac Clin Electrophysiol 1989;12:883-6. Go to original source...
  28. Strasberg B, Sclarovsky S, Arditti A, Lewin RF, Agmon J. Deep inspiration induced sinus arrest. An unusual manifestation in a patient with the sick sinus syndrome. J Electrocardiol 1986;19:91-2. Go to original source... Go to PubMed...
  29. Haumer M, Geppert A, Karth GD, et al. Transient swallow syncope during periods of hypoxia in a 67-year-old patient after self-extubation. Case Reports. Crit Care Med 2000;28:1635-7. Go to original source...
  30. Schluger J, Travers JH, Wolf RE, Green JM. Sinus arrest induced by swallowing and propranolol. Chest 1973;64:651-3. Go to original source... Go to PubMed...
  31. Nakagawa M, Takahashi N, Yufu K, et al. Malignant neurocardiogenic vasovagal syncope associated with chronic exaggerated vagal tone. PACE 2000;23:1695-7. Go to original source... Go to PubMed...
  32. Oddone D, Brignole M, Menozzi C, Gianfranchii L, Lolli G. Spontaneous occurrence of the induced cardioinhibitory vasovagal reflex. Pac Clin Electrophysiol 1991;14:415-9. Go to original source... Go to PubMed...
  33. Graham LA, Kenny RA. Clinical characteristics of patients with vasovagal reactions presenting as unexplained syncope. Europace 2001;3:141-6. Go to original source... Go to PubMed...
  34. Seidl K, Rameken M, Breunung S, et al. Diagnostic assessment of recurrent unexplained syncope with a new subcutaneously implantable loop recorder. Europace 2000;2:256-62. Go to original source... Go to PubMed...




Cor et Vasa

You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.