Pacing and clinical electrophysiology : PACE
-
Swallow syncope is a rare disorder caused by hypersensitive vagotonic reflex in response to deglutition. A 26-year-old man complained of recurrent light-headedness and near syncope on swallowing was hospitalized for monitoring and evaluation. ⋯ This patient received a Medtronic Kappa (401B) DDDR pacemaker with the rate drop feature. The patient has remained asymptomatic on follow-up for the past 2 years.
-
Pacing Clin Electrophysiol · Mar 2003
Relationship among the severity of sleep apnea syndrome, cardiac arrhythmias, and autonomic imbalance.
The relationship between obstructive sleep apnea syndrome (OSAS), cardiac arrhythmias, and conduction disturbances in adults remains controversial. Early studies showed a higher prevalence than more recent and designed epidemiological studies. To clarify the actual prevalence of cardiac arrhythmias and conduction disturbances in patients referred for assessment of OSAS, a prospective cohort study was conducted: 147 consecutive patients (103 men; mean age of 54.5 +/- 10.7 years) underwent time-synchronized polysomnography and ECG Holter monitoring. ⋯ Moreover, using heart rate variability analysis, nocturnal sinusal dysfunction contrasted with a blunted diurnal parasympathetic modulation of the sinus node. Frequent nocturnal nonsustained supraventricular tachycardias were predominantly found in patients with severe sleep related breathing disorders; however, an increased risk of ventricular arrhythmias was not found. Under continuous positive airway pressure treatment, the 1-year follow-up of OSAS patients with nocturnal pauses did not reveal any arrhythmic event justifying a specific intervention.
-
Pacing Clin Electrophysiol · Mar 2003
Case ReportsTorsades de pointes and QT prolongation due to a combination of loratadine and amiodarone.
Torsades de pointes (TdP) has not been previously reported with loratadine. A 73-year old woman on chronic treatment with amiodarone for atrial fibrillation received loratadine and presented with syncope and multiple episodes of TdP. We suggest that QT interval should be monitored whenever loratadine is co-administered with drugs that may potentially prolong QT.