RESUMO
A patient who had been previously diagnosed with congenital complete atrioventricular block (CCAVB) twenty years ago developed atrioventricular (AV) conduction through an accessory pathway (AP). With enhanced sympathetic tone (exercise, isoproterenol), 1:1 conduction down the AP occurred. An electrophysiologic study confirmed a suprahissian AV block and the presence of an AP. The AP was located on the left side and posterior. The absence of retrograde conduction through the AP and also a long conduction time were demonstrated.
Assuntos
Bloqueio Cardíaco/diagnóstico , Cardiopatias Congênitas/diagnóstico , Síndromes de Pré-Excitação/diagnóstico , Adulto , Nó Atrioventricular/fisiopatologia , Estimulação Cardíaca Artificial , Eletrocardiografia , Técnicas Eletrofisiológicas Cardíacas , Feminino , Bloqueio Cardíaco/fisiopatologia , Sistema de Condução Cardíaco/fisiopatologia , Cardiopatias Congênitas/fisiopatologia , Humanos , Síndromes de Pré-Excitação/fisiopatologiaRESUMO
OBJECTIVE: To review our experience on using an implantable loop recorder (ILR) in patients with recurrent falls, when an arrhythmogenic cause is suspected. MATERIAL AND METHODS: This is a retrospective, observational study of patients with repetitive unexplained falls, suspected syncope, or electrocardiographic abnormalities. All of them had been evaluated by a cardiologist, who decided to implant a loop recorder (ILR) for an accurate diagnosis. RESULTS: A total of 13 patients received an ILR. The average falls rate for the sample was 3.3. The mean age was 78 years, and 46% were female, with a mean follow-up period of 24 months. During this time, three patients did not suffer from a new fall. An arrhythmogenic diagnosis was obtained in 5 patients: bradycardia was identified in 4 cases, and tachycardia in one of them. The symptoms did not coincide with a documented arrhythmia in the rest of the patients. CONCLUSION: ILR is a helpful tool to establish an arrhythmogenic cause of unexplained and recurrent falls, in this selected sample of older adults.