Features suggestive of an isolated increase in vagal tone during electrophysiological study were found in 12 patients with recurrent near syncope or syncope. Results at neurological and cardiac evaluation were otherwise normal. The increased tone or heightened sensitivity to vagal tone was manifested by abnormal atrioventricular nodal refractoriness and conduction that were reversed with atropine. The patients underwent long term treatment with an anticholinergic agent (propantheline bromide) and 75% improved. Before treatment they had experienced a median of seven episodes (range 3-28) of near syncope or syncope during 10.5 months (range 1-60). During treatment these episodes decreased to a median of one (range 0-15) during 22.5 months (range 3-67); six patients experienced no further symptoms. Three patients continued to have syncope while on treatment, and one of these required permanent cardiac pacing. No additional cause for syncope was identified in any patient. During electrophysiological assessment of patients with syncope, evidence may be obtained pointing to an increase in vagal tone. In many of these patients treatment with anticholinergic drugs seemed to improve or eliminate the symptoms.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.