Spontaneous Asystolic Pauses: How Frequent Is a Neuromediated Mechanism?
In a patient evaluated for syncope, the recording of a symptomatic ventricular asystole during electrocardiographic monitoring is usually regarded as a sign of severe dysfunction of the sinoatrial node or of the atrioventricular node with an ominous outcome; therefore pacemaker therapy is usually initiated. Recent studies have shown that a neurocardiogenic mechanism is the hidden, real cause of syncope in most patients presenting with asystolic pauses, which mistakenly suggest another cause for syncope. The identification of the neurocardiogenic mechanism has important clinical implications for prognosis and therapy.
KeywordsSick Sinus Syndrome Syncopic Episode Versus Block Sinus Arrest Electrocardiographic Monitoring
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