Key result
Atrioventricular node ablation and dual chamber pacemaker implantation dramatically improved symptoms and eliminated syncope in a 42-year-old woman with refractory postural tachycardia syndrome.
Why the study?
Does atrioventricular node ablation and pacemaker implantation improve symptoms in a patient with refractory POTS?
Case Report (n=1)
Does atrioventricular node ablation and pacemaker implantation improve symptoms in a patient with refractory POTS?
Atrioventricular node ablation and pacemaker implantation may be an effective last-resort treatment for highly refractory POTS with recurrent syncope.
May support AV node ablation plus pacing as last-resort for refractory POTS with syncope; leaves open need for prospective trials before adoption.
Ablate and pace for POTS. A 42-year-old woman with postural tachycardia syndrome (POTS) was admitted to our hospital with severe palpitations, light-headedness, and syncope. Several drugs had been administered previously, but all had been discontinued due to intolerable adverse effects or limited efficacy. One of the drugs, the I(f) current inhibitor ivabradine, effectively slowed the patient's heart rate and relieved the symptoms, but was discontinued due to allergy. After unsuccessful sinus node ablation, atrioventricular node ablation and dual chamber pacemaker implantation was performed, which dramatically improved her symptoms and eliminated syncope. Atrioventricular node ablation could modify the cardiac autonomic balance and thereby suppressed the excessive orthostatic sympathetic activity.
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Nakatani et al. (2011) conducted a case report in Postural tachycardia syndrome (POTS) (n=1). Atrioventricular node ablation and dual chamber pacemaker implantation was evaluated on Symptom improvement and syncope elimination. Atrioventricular node ablation and dual chamber pacemaker implantation dramatically improved symptoms and eliminated syncope in a 42-year-old woman with refractory postural tachycardia syndrome.
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