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Proximal Coronary Sinus Pacing Induced Prolonged Asystole Publisher



Madadi S1 ; Shahabi J2 ; Moeini M3 ; Kamali F1
Authors
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Authors Affiliations
  1. 1. Department of Cardiac Electrophysiology AND Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

Source: ARYA Atherosclerosis Published:2022


Abstract

BACKGROUND: Atrioventricular node (AVN) is an interatrial septum structure located at the apex of triangle of Koch that modulates the transmission of impulses from atria to the ventricles. Vagally mediated AVN block with high frequency stimulation (HFS) was investigated in a few animal and human studies, but prolonged ventricular asystole that was induced by a low frequency proximal coronary sinus (CS) overdrive pacing has rarely been reported. CASE REPORT: A 40-year-old man was admitted in our hospital for evaluation of syncope and palpitation. He presented with prolonged ventricular asystole by proximal CS pacing during electrophysiological study (EPS). CONCLUSION: There is no comprehensive clinical study to investigate the association of vasovagal syncope with vagally mediated atrioventricular block (AVB) which is induced by posteroseptal area stimulation. Radiofrequency catheter ablation of ganglionated plexi (GP) located close to sinus node and AVN was reported to eliminate the vagal efferent output during vasovagal syncope as a new treatment strategy. © 2022, Isfahan University of Medical Sciences(IUMS). All rights reserved.
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