Sudden Wenckebach periods and their relationship to neurocardiogenic syncope

PACE - Pacing and Clinical Electrophysiology

Volumn 21, Issue 8, 1998, Pages 1580-1588

  Castellanos, Agustin ^a   Moleiro, Federico ^a   Acosta, Helbert ^a   Ferreira, Alexandre ^a   Cox, Marilyn M ^a   Interian Jr , Alberto ^a   Myerburg, Robert J ^a  

^a UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE   (United States)

Author keywords

Apparent type II A V block; Neurocardiogenic syncope; Paroxysmal A V block; Type I A V block; Vagal block

Indexed keywords

PROPRANOLOL;

ADULT; ARTICLE; ATRIOVENTRICULAR BLOCK; CLINICAL ARTICLE; CONTROLLED STUDY; FEMALE; HEART CYCLE; HEART FUNCTION TEST; HOLTER MONITORING; HUMAN; MALE; ORAL DRUG ADMINISTRATION; P WAVE; PR INTERVAL; SINUS TACHYCARDIA; SYMPTOMATOLOGY; SYNCOPE; WENCKEBACH PERIOD;

ACUTE DISEASE; ADULT; ELECTROCARDIOGRAPHY, AMBULATORY; FEMALE; FOLLOW-UP STUDIES; HEART BLOCK; HEART RATE; HUMANS; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; SYNCOPE, VASOVAGAL;

EID: 0031828958     PISSN: 01478389     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1540-8159.1998.tb00246.x     Document Type: Article

References (50)

1. Rardon DP, Miles W, Mitrani R, et al. Atrioventricular block and dissociation. In DP Zipes, J Jalife (eds.): Cardiac Electrophysiology. From Cell to Bedside. Second Edition. Philadelphia, PA, Saunders, 1995, pp. 935-942.
2. Wagner GS. Marriot's Practical Electrocardiography. Baltimore, MD, Williams & Wilkins, 1994, pp. 388-391.
3. Schamroth L. The Disorders of Cardiac Rhythm. Second Edition. Oxford, Blackwell Scientific Publications, 1980, pp. 317-323.
4. Fisch C. Electrocardiography of Arrhythmias. Philadelphia, PA, Lea and Febiger, 1990, pp. 355-357,381.
5. Pick A, Langendorf R. Interpretation of Complex Arrhythmias. Philadelphia, PA, Lea and Febiger, 1979, pp. 217-222, 496.
6. Zipes DP. Specific arrhythmias. Diagnosis and treatment. In E Braunwald (ed.): Heart Disease. Fifth Edition. Philadelphia, PA, Saunders, 1997, pp. 687-689.
7. Ursell S, Habbab MA, El-Sherif N, et al. Atrioventricular and intraventricular conduction disorders. In N El-Sherif, P Samet (eds.): Cardiac Pacing and Electrophysiology. Third Edition. Philadelphia, PA, Saunders, 1991, pp. 140-169.
8. Denes P, Levy L, Pica A, et al. The incidence of typical and atypical AV Wenckebach periodicity. AV Wenckebach periodicity. Am Heart J 1975; 89:26-31.
9. Electrocardiography Self-Assessment Program (ECG-SAPI). Answers and Commentary. American College of Cardiology, Bethesda, MD, 1995, Question 13, page 100 of Examination Book and page 33 of Answers and Commentary.
10. Massie B, Scheinman MM, Peters R, et al. Clinical and electrophysiologic findings in patients with paroxysmal slowing of the sinus rate and apparent Mobitz type II atrioventricular block. Circulation 1978; 58:2:305-314
11. Zaman L, Moleiro F, Rozanski JJ, et al. Multiple electrophysiologic manifestations and clinical implications of vagally mediated AV block. Am Heart J 1983; 106:1:I:92-99.
12. Gambetta M, Denes P, Childers RW. Vagally induced second degree A-V block Mobitz type I, and the hyporeactive SA node. Chest 1972; 62:2:152-155.
13. Rosen KM, Loeb HS, Gunnar RM, et al. Mobitz type II block without bundle branch block. Circulation 1969; 39:13.
14. Lange HW, Ameisen O, Mack R, et al. Prevalence and clinical correlations of non-Wenckebach narrow-complex second-degree atrioventricular block detected by ambulatory ECG. Am Hear J 1988; 115:114-120.
15. Mobitz W. Über die unvollstandige Storung der Erregung überleitung zwischen Vorhof und Kammer des menschlichen Herzens. Z Ges Exp Med 1928; 4:180-237.
16. Narula OS, Scherlag BJ, Samet P, et al. Atrioventricular block. Localization and classification by His bundle recordings. Am J Med 1971; 50:146-158.
17. WHO/ISC Task Force. Definition of terms related to cardiac rhythm. Am Heart J 1978; 95:796-806.
18. Barold S. ACC/AHA Guidelines for Implantation of Cardiac Pacemakers. How accurate are the definitions of atrioventricular and intraventricular conduction blocks? PACE 1993; 16:1221-1226.
19. Kastor JA. Arrhythmias. WB Saunders, Philadelphia, PA, 1994, pp. 157-159.
20. Sachs A, Traynor RL. Paroxysmal auriculo-ventricular heart block. Am Heart J 1933; 9:267-271.
21. Rosenbaum MB, Elizari MV, Levi RJ. Paroxysmal atrioventricular block related to hypopolarization and spontaneous diastolic depolarization. Chest 1973; 63:678.
22. Dreifus LS, Gillette PC, Fisch C, et al. Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices. A report of the American College of Cardiology/American Heart Association Task Force on assessment of diagnostic and therapeutic cardiovascular procedures (Committee on Pacemaker Implantation). J Am Coll Cardiol 1991; 18:1-13.
23. Cox MM, Perlman BA, Mayor MR, et al. Acute and long-term beta-adrenergic blockade for patients with neurocardiogenic syncope. J Am Coll Cardiol 1995; 26:1293-1298.
24. Daubert JC, Mabo P, Gras D, et al. Role of permanent cardiac pacing in vasovagal syncope. In JJ Blanc, D Bendill, R Sutton (eds.): Neurally-Mediated Syncope: Pathophysiology, Investigations and Treatment. Futura Publishing Company, Armonk, NY, 1996, pp. 119-126.
25. Meytes I, Kaplinsky E, Yahini JH, et al. Wenckebach A-V block: A frequent feature following heavy physical training. Am Heart J 1975; 90:4:426-430.
26. Talan DA, Bauernfeind RA, Ashley WV, et al. Twenty-four hour continuous ECG recordings in long-distance runners. Chest 1982; 82:1:19-23.
27. Lightfoot PR, Sasse L, Mandel WJ, et al. His bundle electrograms in healthy adolescents with persistent second degree AV block. Chest 1973; 63:358-368.
28. Brodsky M, Wu D, Denes P, et al. Arrhythmias documented by 24 hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease. Am J Cardiol 1977; 39:390-395.
29. Moore EN, Spear JF. Effects of autonomic activity on pacemaker function and conduction. In HJJ Wellens, KI Lie, MJ Janse (eds.): The Conduction System of the Heart. Structure, Function, and Clinical Implications. Leiden, HE Stenfert Kroese BV, 1976, p. 100.
30. Kenny RA, Imgram A, Bayliss J, et al. Head-up tilt: A useful test for investigating unexplained syncope. Lancet 1986; 2:1352-1354.
31. Dhala A, Natale A, Sra J, et al. Relevance of asystole during head-up tilt testing. Am J Cardiol 1995; 75:251-254.
32. Sutton R, Petersen MEV. The clinical spectrum of neurocardiogenic syncope. J Cardiovasc Electrophysiol 1995; 6:569-576.
33. Brignole M, Menozzi C. Methods other than tilt testing for diagnosing neurocardiogenic (neurally mediated) syncope. PACE 1997; 20:795-800.
34. Benditt DG, Erickson M, Gammage MD, et al. A synopsis: Neurocardiogenic syncope, an international symposium, 1996. PACE 1997; 20:851-860.
35. Petersen MEV, Sutton R. Cardiac pacing for vasovagal syncope: A reasonable therapeutic option? PACE 1997; 20:824-826.
36. Takase B, Kurita A, Nagai T, et al. Autonomic nervous system activity in daily life in patients with neurally mediated syncope; the assessment of heart rate variability from 24-hour holler monitoring, (abstract) J Am Coll Cardiol 1996; 737-4:146A.
37. Jaeger FJ, Fouad-Tarazi FM, Castle LW. Carotid sinus hypersensitivity and neurally mediated syncope. In KA Ellenbogen, GN Kay, BC Wilkoff (eds.): Clinical Cardiac Pacing. WB Saunders, Philadelphia, PA, 1995, pp. 333-352.
38. Folino AF, Buja GF, Martini B, et al. Prolonged cardiac arrest and complete AV block during upright tilt test in young patients with syncope of unknown origin-prognostic and therapeutic implications. Eur Heart J 1992; 13:1416-1421.
39. Brignole M, Menozzi C, Bottoni N, et al. Mechanisms of syncope caused by transient bradycardia and the diagnostic value of electrophysiologic testing and cardiovascular reflexivity maneuvers. Am J Cardiol 1995; 76:273-278.
40. Fitzpatrick A, Sutton A. Tilting towards a diagnosis in recurrent unexplained syncope. Lancet 1989; 1:658
41. Jaeger Jr. FJ, Pinski SL, Trohman RG, et al. Paradoxical failure of QT prolongation during cardioinhibitory neurocardiogenic syncope. Am J Cardiol 1997; 79:100-102.
42. Benditt D, Gammage M, Sutton R, et al. Neurocardiogenic syncope. PACE 1997; 20:3:751-860.
43. Krahn AD, Yee R, Klein GJ, et al. Inappropriate sinus tachycardia: Evaluation and therapy. J Cardiovasc Electrophysiol 1995; 6:1124-1128.
44. Bauerfeind RA, Amat-y-Leon F, Dhingra R, et al. Chronic nonparoxysmal sinus tachycardia in otherwise healthy persons. Ann Intern Med 1979; 91:702-710.
45. Trohman RG, Pinski SL, Fouad F, et al. Inappropriate sinus tachycardia and head-up tilt: Is heart rate just the tip of the iceberg? (abstract) PACE 1996; 19:710.
46. Castellanos A, Moleiro F, Chakko S, et al. Heart rate variability in inappropriate sinus tachycardia. (abstract) PACE 1997; 20:1176.
47. Grubb BP, Kosinski D. Tilt table testing: Concepts and limitations. PACE 1997; 20:781-787.
48. Rizzon P, Di Biase M. Effects of carotid sinus reflex on cardiac impulse formation and conduction. Electrophysiologic study. In PJ Schwartz, AM Brown, A Malliani, et al. (eds.): Neural Mechanisms in Cardiac Arrhythmias. Raven Press, New York, 1978, p. 345.
49. Strasberg B, Lam W, Swiryn S, et al. Symptomatic spontaneous paroxysmal AV nodal block due to localized hyperresponsiveness of the AV node to vagotonic reflexes. Am Heart J 1982; 103:795-801.
50. Castellanos A, Alatriste VM, Sung RJ. Relationship between alternating Wenckebach periods and paroxysmal block in the A-V node. In B Befeler, R Lazzara, BJ Sherlag (eds.): Selected Topics in Cardiac Arrhythmias. Futura Publishing Company, Armonk, NY, 1980, pp. 307-321.