Key result
Atropine administration reverted all electrophysiological abnormalities to normal in 13 patients with unexplained syncope and isolated AV node abnormalities, indicating selective hypervagotonia.
Why the study?
Recurrent unexplained syncope or presyncope with isolated electrophysiological abnormalities in the atrioventricular node had not been characterized as selective hypervagotonia.
Observational (n=13)
Answers are grounded in this paper and cite their sources.
Supports hypervagotonia in select unexplained syncope; leaves open need for prospective validation before clinical adoption.
Thirteen patients with recurrent unexplained syncope or presyncope underwent electrophysiological evaluation. A prolonged effective refractory period and functional refractory period of the atrioventricular node as well as slow paced rate to atrioventricular block were the only abnormalities found. Ventricular tachycardia could not be induced. All electrophysiological abnormalities reverted to normal following atropine administration. These patients have selective hypervagotonia isolated to the atrioventricular node. Three of thirteen patients required permanent pacing, and one required propantheline to control recurrent symptoms. Selective hypervagotonia may be a distinct clinical entity that can cause symptoms and require therapy.
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Rubin et al. (1988) conducted an observational in Recurrent unexplained syncope or presyncope (n=13). Atropine administration was evaluated on Reversion of electrophysiological abnormalities to normal. Atropine administration reverted all electrophysiological abnormalities to normal in 13 patients with unexplained syncope and isolated AV node abnormalities, indicating selective hypervagotonia.
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