The young man with recurrent syncope
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The young man with recurrent syncope
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View a larger zoom of the event here:
The captured event shows an acceleration of sinus rhythm followed by an abrupt decrease in rate and then a sinus pause of about 6.5 seconds. This is suggestive of an cardioinhibitory type of neurally-mediated syncope. HUT is reported to be positive in two-thirds to three-fourth of patients with neurally-mediated syncope. When positive, it is pretty reassuring both for the patient and the physician that a benign cause for syncope is found. But when negative, one should look for other causes. Implantable loop recorders may have an important role in the diagnosis of unexplained cases of syncope. What treatment would you recommend? |
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