A 79 year old woman with multiple comorbidities was diagnosed with paroxysmal AV Block with the help of carotid sinus massage and prolonged ECG monitoring. She was then treatment with a dual chamber pacemaker.
A 79‐year‐old hypertensive woman presented with recurrent episodes of syncope over a month, increasing in frequency over the last 3 days.
Echocardiography revealed fair left ventricular contractility, mild aortic stenosis, marked mitral annular calcification, mild mitral stenosis and mild mitral regurgitation.
Baseline ECG was normal.
Carotid sinus massage triggered a paroxysmal AV block with slowing of sinus rate, associated with near‐syncope;
During hospital stay, the patient went intermittently into complete AV block,often with near‐syncope;
The patient was started on isoprenaline infusion at 2 µg/min, with which the episodes subsided.
Subsequently, a dual‐chamber pacemaker was implanted, with alleviation of symptoms.
"What is the mechanism of paroxysmal atrioventricular block in a patient with recurrent syncope? - Bansal - 2019 - Journal of Arrhythmia - Wiley Online Library".
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