Cough Syncope Presenting as Mobitz Type II Atrioventricular Block—An Electrophysiologic Correlation

Baron, Scott B.; Huang, Shoei K. Stephen

doi:10.1111/j.1540-8159.1987.tb05925.x

Cited by 26 publications

(8 citation statements)

References 15 publications

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“…Electrophysiological studies have been carried out in patients with episodes of vagally mediated second- or third-degree AV block, including pseudo-Mobitz II block 1 3 6 7 10 11. In the majority of patients, AH and HV intervals are normal or slightly prolonged; the slight prolongation is unlikely to have a cause–effect relationship with the advanced-degree or complete AV blocks, some of which are accompanied by ventricular asystole.…”

Section: Electrophysiological Findings Of Vagally Mediated Av Blockmentioning

confidence: 99%

Vagally mediated atrioventricular block: pathophysiology and diagnosis

Alboni¹,

Holz²,

Brignole

2013

Heart

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Vagally mediated atrioventricular (AV) block is defined as a paroxysmal AV block, localised within the AV node, associated with slowing of the sinus rate. All types of second-degree AV block, including pseudo-Mobitz II block, and complete AV block, may be present. Most of the patients have normal AV conduction. Differential diagnosis with intrinsic AV block is based on the behaviour of the sinus rate. Vagally mediated AV block is benign; it can be recorded as an asymptomatic or symptomatic event (syncope/presyncope). Syncope due to this form of AV block should be diagnosed and managed as neurally mediated syncope. When this block is fortuitously recorded in asymptomatic patients, pacemaker implantation is not indicated.

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Section: Electrophysiological Findings Of Vagally Mediated Av Blockmentioning

confidence: 99%

Vagally mediated atrioventricular block: pathophysiology and diagnosis

Alboni¹,

Holz²,

Brignole

2013

Heart

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“…For example, atrioventricular conduction block due to hypersensitive broncho-pulmonary reflex, a neurally-mediated reflex contributing to an inappropriate chronotropic response or a premature ventricular complex, may cause cough-induced syncope. 1,[5][6][7][8] Cough-induced syncope in the patient described above was associated with hypotension. Bradycardia or arrhythmias were not documented during the episodes.…”

Section: Discussionmentioning

confidence: 84%

Cough-Induced Syncope as an Unusual Manifestation of Pericardial Effusion

El-Osta¹,

Ashfaq²

2008

kjm

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“…13,[19][20][21] Some studies demonstrated that vagal activity could modify AV conduction to produce first degree to complete heart block including Mobitz type II. 13,[20][21][22][23][24][25] For vagally mediated AV block, the decision regarding the use of pacemakers is not based on the type of block or on QRS duration but on the underlying clinical settings and the correlation of symptoms. 2 6 For all our patients with second degree AV block, the prognosis was benign, because they had narrow QRS complexes and only occurred transiently during spinal anesthesia without significant ventricular pause.…”

Section: Discussionmentioning

confidence: 99%

Arrhythmias during spinal anesthesia for Cesarean section

Shen¹,

Ho²,

Hung³

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: Spinal block has long been considered a safe anesthesia technique for surgery. However, severe bradycardia, cardiac arrest, and other arrhythmias during spinal anesthesia have been reported and the incidence of intraoperative arrhythmias is not well established. In this study the incidence of arrhythmias during spinal anesthesia was determined. Methods:We studied 254 healthy women undergoing Cesarean section under spinal anesthesia prospectively. Spinal anesthesia with 10 mg bupivacaine mixed with 0.2 mg morphine was performed at the L 3-4 interspace. Intraoperative arrhythmias were recorded and verified later by a cardiologist.Results: First degree atrioventricular block developed in nine patients (3.5%), second degree atrioventricular block in nine (3.5%), severe bradycardia (heart rate < 50 beats·min -1 ) in seventeen (6.7%), multiple VPC in three (1.2%). The height and weight of patients with severe bradycardia, multiple VPCs, or atrioventricular block were not different from those of the other patients. However, the age of patients in the potentially dangerous arrhythmias group was greater than that in the other group (P = 0.006). Conclusion:The incidence of arrhythmias as well as hypotension during spinal anesthesia for Cesarean section was higher than expected. Although most of these arrhythmias were transient and recovered spontaneously, they might unexpectedly occur and sometimes need immediate and prompt treatment. It is necessary to remain vigilant during spinal anesthesia for Cesarean section and careful monitoring of these patients is warranted, especially in older parturients.Objectif : On a longtemps considéré la rachianesthésie comme une technique sécuritaire pour la chirurgie. Cependant, des cas de bradycardie sévère, d'arrêt cardiaque et d'autres arythmies ont été signalés pendant la rachianesthésie et l'incidence d'arythmie peropératoire n'est pas bien définie. Dans la présente étude, on a déter-miné l'incidence d'arythmie pendant la rachianesthésie.Méthode : Nous avons fait l'étude prospective de 254 femmes en santé qui ont subi une césarienne sous rachianesthésie. L'injection de 10 mg de bupivacaïne avec 0,2 mg de morphine a été réalisée dans l'espace L 3-4 . L'arythmie peropératoire a été notée et vérifiée ensuite par un cardiologue.Résultats : Un bloc auriculoventriculaire de premier degré s'est développé chez neuf patientes (3,5 %), un bloc de second degré chez neuf patientes également (3,5 %), une bradycardie sévère (fréquence cardiaque < 50 battements·min -1 ) chez dix-sept (6,7 %), de multiples ESV chez trois (1,2 %). La grandeur et le poids des patientes qui ont présenté une bradycardie sévère, de multiples ESV ou un bloc auriculoventriculaire ne différaient pas de ceux des autres patientes. Toutefois, les patientes du groupe présentant des arythmies potentiellement dangereuses étaient plus âgées que les autres (P = 0,006).Conclusion : L'incidence d'arythmie autant que d'hypotension pendant la rachianesthésie pour une césarienne a été plus élevée que prévu. Même si la plupart...

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Cough Syncope Presenting as Mobitz Type II Atrioventricular Block—An Electrophysiologic Correlation

Cited by 26 publications

References 15 publications

Vagally mediated atrioventricular block: pathophysiology and diagnosis

Vagally mediated atrioventricular block: pathophysiology and diagnosis

Cough-Induced Syncope as an Unusual Manifestation of Pericardial Effusion

Arrhythmias during spinal anesthesia for Cesarean section

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