Usefulness of adenosine to detect advanced paroxysmal atrioventricular block as a cause of syncope

We present the case of a 66 years old man with recurrent episodes of syncope, up to three times during the last two months without previous symptoms. An ECG after the syncope showed a bilateral block (left anterior fascicle block and right bundle branch block) and first grade atrioventricular block....

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Bibliographic Details
Published in:Archivos de cardiología de México 2002-07, Vol.72 (3), p.227-232
Main Authors: Guevara-Valdivia, Milton E, Iturralde Torres, Pedro, de Micheli, Alfredo, Huarte Hernández, Yaeli, Colín Lizalde, Luis, González-Hermosillo, J A
Format: Article
Language:Spanish
Subjects:
Adenosine
Aged
Disease Progression
Electrocardiography
Heart Block - complications
Heart Block - diagnosis
Heart Block - physiopathology
Humans
Male
Syncope - etiology
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Summary:We present the case of a 66 years old man with recurrent episodes of syncope, up to three times during the last two months without previous symptoms. An ECG after the syncope showed a bilateral block (left anterior fascicle block and right bundle branch block) and first grade atrioventricular block. The exercise test did not demonstrate either AV conduction disorders or tachyarrhythmia episodes. Holter monitoring showed premature ventricular complexes; tilt testing and carotid sinus massage were normal. The electrophysiologic study revealed no alteration in the conduction system. Throughout atrial and ventricular stimulation documented no tachyarrhythmias. However, intravenous administration of 12 mg of adenosine induced complete AV infra-His block with ventricular asystolia of 7.2 sec duration. Adenosine testing can identify patients with syncope due to paroxysmal AV block even when the electrophysiological findings and other conventional tests are not conclusive.
ISSN:1405-9940