Intermittent Ventricular Standstill During Chronic Atrial Fibrillation in Patients with Dizziness or Syncope

• Published in: Pacing and clinical electrophysiology 1987-11, Vol.10 (6), p.1271-1276
• Main Authors: REBELLO, ROSARIO, BROWNLEE, WILLIAM C.
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Aged, 80 and over; atrial fibrillation; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Chronic Disease; Combined Modality Therapy; Digoxin - therapeutic use; Dizziness - physiopathology; Electrocardiography; Female; Heart Block - physiopathology; Heart Ventricles - physiopathology; Humans; Male; Middle Aged; Monitoring, Physiologic; Pacemaker, Artificial; permanent cardiac pacing; syncope; Syncope - physiopathology; ventricular standstill
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.1987.tb04963.x

Thirty‐two patients with atrial fibrillation and normal ventricular rates who complained of dizziness or loss of consciousness underwent 24‐hour ambulatory electrocardiographic monitoring. A control group of 25 patients in atrial fibrillation but without symptoms of dizziness or loss of consciousness was likewise investigated. All patients remained in atrial fibrillation; periods of ventricular standstill (mean, 2.9; range, 1.8–8.0) were present in 31 symptomatic patients but in only three of the control patients (mean, 1.9 s; range, 1.7–2.4). Twenty‐three symptomatic patients with pauses ± 2.0 s received a demand pacemaker. Following pacing, nineteen became completely asymptomatic; four patients continued to have dizziness but three of these, who also experienced syncope, no longer did so (mean follow‐up, 13 months; range, 6–30). It is suggested that ventricular standstill may commonly occur in patients with controlled atrial fibrillation who complain of dizziness or syncope and that the majority will benefit from permanent cardiac pacing.