Why the study?
Does oral propranolol therapy prevent AV block and syncope in a patient with neurocardiogenic syncope?
Does oral propranolol therapy prevent AV block and syncope in a patient with neurocardiogenic syncope?
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Head-up tilt testing can identify neurocardiogenic syncope as a cause of paroxysmal AV block, which may be successfully treated with beta-blockers rather than a pacemaker.
A 26-year old woman, who experienced syncope associated with advanced AV block, was referred for further evaluation. Electrophysiological study showed normal SA and AV node physiology. Syncope associated with advanced AV block on the electrocardiogram was induced by head-up tilt test. Oral propranolol therapy completely prevented the AV block and syncope induced by head-up tilt. The physician should be aware of advanced AV block associated with neurocardiogenic syncope, especially before permanent - pacemaker therapy is considered. The head-up tilt test is a useful diagnostic tool for an etiology of paroxysmal AV block.
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Abe et al. (1999) studied this question.
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