ARYA Atherosclerosis Journal

Proximal coronary sinus pacing induced prolonged asystole

Document Type : Case Report

Authors

Shabnam Madadi 1
Javad Shahabi 2
Mahdi Moeini 3
Farzad Kamali 4

1 Associate Professor, Department of Cardiac Electrophysiology AND Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

2 Assistant Professor, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

4 Assistant Professor, Department of Cardiac Electrophysiology AND Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

https://doi.org/10.22122/arya.v17i0.2169
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.

Keywords

Proximal coronary sinus
Pacing
Asystole
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ARYA Atherosclerosis Journal
Volume 17, Issue 1
January and February 2021
Pages 1-4

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