March 1, 1988Pacing and Clinical Electrophysiology
Evaluation of Patients with Bundle Branch Block and “Unexplained” Syncope: A Study Based on Comprehensive Electrophysiologic Testing and Ajmaline Stress
Why the study?
Does comprehensive electrophysiologic testing with ajmaline stress identify the etiology of unexplained syncope in patients with bundle branch block?
Population
35 patients with bundle branch block and unexplained syncope
Design
Cohort
Follow-up
mean 16.5 +/- 9.2 months
Authors
Discussion
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Member takes
Overview
EP testing with ajmaline may identify treatable causes in BBB syncope; leaves open whether it improves outcomes over standard care.
Structured PICO
Does comprehensive electrophysiologic testing with ajmaline stress identify the etiology of unexplained syncope in patients with bundle branch block?
P
Population
35 patients with bundle branch block (BBB) and unexplained syncope (20 with structural heart disease, 15 with no significant heart disease)
I
Intervention
Electrophysiologic study (EPS) including programmed ventricular stimulation and ajmaline administration (1 mg/kg, IV)
O
Outcome
Clinically significant electrophysiologic abnormalities (prolonged HV interval, ajmaline-induced HV block, or inducible ventricular tachycardia)surrogate
Comprehensive electrophysiologic testing, including ajmaline stress, identifies a potential arrhythmic cause in approximately 60% of patients with bundle branch block and unexplained syncope, allowing for effective targeted therapy.
Cite This Study
Kaul et al. (1988) studied this question.