Mechanism of syncope without prodromes with normal heart and normal electrocardiogram

Brignole, Michele; Guieu, Régis; Tomaino, Marco; Iori, Matteo; Ungar, Andrea; Bertolone, Cristina; Unterhuber, Matthias; Bottoni, Nicola; Tesi, Francesca; Deharo, Jean Claude

doi:10.1016/j.hrthm.2016.08.046

Cited by 56 publications

(46 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,226 No syncope recurrence was observed after permanent cardiac pacing in 10 patients who had ECG documentation of asystolic pause due to sinus arrest or AV block. 286 In a small multicentre trial 227 performed in 80 highly selected elderly patients with unexplained unpredictable syncope who had a positive response to intravenous injection of a bolus of 20 mg of ATP, dual-chamber cardiac pacing significantly reduced the 2-year syncope recurrence rate from 69% in the control group to 23% in the active group.…”

Section: Evidence From Trials In Patients With Adenosine-sensitive Symentioning

confidence: 99%

“…In a series of case reports, theophylline appeared effective in patients with recurrent sudden onset (pre)syncope who presented with the common biological characteristic of low circulating adenosine levels. 285,286 Theophylline is a non-selective adenosine receptor antagonist that is potentially effective when adenosine is suspected to be involved in the mechanism of syncope. An intra-patient comparison between a period with and a period without theophylline therapy, with the support of prolonged ECG monitoring, showed that symptoms disappeared and the number of prolonged asystolic pauses was impressively reduced from a median of 1.11 per month during 13 months of no treatment to 0 per month during 20 months of theophylline treatment.…”

Section: Emerging New Therapies In Specific Subgroupsmentioning

confidence: 99%

“…Cardiac pacing may be considered to reduce syncope recurrences in patients with the clinical features of adenosine-sensitive syncope. 5,227,286 IIb B…”

Section: Cardiac Pacingmentioning

confidence: 99%

See 2 more Smart Citations

2018 ESC Guidelines for the diagnosis and management of syncope

Parikka¹

2018

Revista Española de Cardiología (English Edition)

View full text Add to dashboard Cite

Section: Evidence From Trials In Patients With Adenosine-sensitive Symentioning

confidence: 99%

Section: Emerging New Therapies In Specific Subgroupsmentioning

confidence: 99%

See 1 more Smart Citation

2018 ESC Guidelines for the diagnosis and management of syncope

Parikka¹

2018

Revista Española de Cardiología (English Edition)

View full text Add to dashboard Cite

“…These observations may override that of simply pacing AVB. They may also account for the apparently better results of sensing volume ± contractility of the right ventricle in the closed loop system of Biotronik (Berlin, Germany) rather than simply the onset of bradycardia as in the Rate-drop-response of Medtronic (Minneapolis, MN, USA) (11,21,22).…”

Section: Relevance Of Cardiac Pacing To Paroxysmal Atrioventricular Bmentioning

confidence: 99%

Reflex Atrioventricular Block

Sutton

2020

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Reflex atrioventricular block is well-recorded although it is considered rare. Recent data suggests that it is less rare than has been supposed. It has been shown to occur in both vasovagal and carotid sinus reflexes. It has to be distinguished from paroxysmal atrioventricular block due to ventricular conduction tissue disease. Low chronic adenosine levels combined with adenosine release may mimic reflex atrioventricular block. Explanations of the mechanism of these phenomena have been lacking until the recent past. The relevance of reflex atrioventricular block to clinical decision-making is as a possible indication for pacing the heart with consideration given to the vasodepressor component of the reflex.

show abstract

“…Adenosine is an ATP derivative that is implicated in a lot of cardiovascular and neurological diseases including neurocardiogenic syncope [1][2][3], coronary artery diseases [4,5], neuropathic pain [6], septic shock [7] and severe systemic inflammatory response [8]. Thus, measurig adenosine in blood may be helpful for some pathologies.…”

Section: Introductionmentioning

confidence: 99%

Rapid Measurement of Adenosine Concentration in Human Blood Using Fixed Potential Amperometry: Comparison with Mass Spectrometry and High- Performance Liquid Chromatography

Marlinge¹,

Vairo²,

Marolda³

et al. 2017

J Anal Bioanal Tech

Self Cite

View full text Add to dashboard Cite

Background: Adenosine is a nucleoside that impacts the cardiovascular system during cardiovascular or inflammatory diseases. The rapid determination of adenosine in blood may be useful in emergency medicine especially in syncope diagnose or septic shock. We compare its measurement in blood using fixed potential amperometry (FPA), with usual methods: mass spectrometry (LC-MS/MS) or high performance liquid chromatography (HPLC). Methods:Twenty healthy subjects (14 men and 6 women) and ten patients suffering from vasovagal syncope (VVS, 6 women and 4 men) were included. Blood samples were collected by vein puncture for plasma adenosine assay and in the same time using finger puncture for direct FAP measurement and on blotting paper for LC-MS/MS. Results:Mean plasma adenosine concentration was 26% higher using HPLC compared with LC-MSMS; p<0.01. In whole blood, adenosine concentration was 35% higher using FPA compared with LC-MS/MS. We found a good correlation between adenosine values measured by FAP and LC-MS/MS in whole blood and between LC-MS/MS and HPLC in plasma. Mean adenosine concentration was higher in patients whatever the method used. Conclusion:Adenosine measurement to the patient's bed, using FPA may be useful in some cases where high adenosine is associated with pejorative outcome.

show abstract

Mechanism of syncope without prodromes with normal heart and normal electrocardiogram

Cited by 56 publications

References 18 publications

2018 ESC Guidelines for the diagnosis and management of syncope

2018 ESC Guidelines for the diagnosis and management of syncope

Reflex Atrioventricular Block

Rapid Measurement of Adenosine Concentration in Human Blood Using Fixed Potential Amperometry: Comparison with Mass Spectrometry and High- Performance Liquid Chromatography

Contact Info

Product

Resources

About