An 18 year old girl presented with frequent vasovagal attacks and sinus arrhythmia. The amplitude of respiratory sinus arrhythmia assessed by cosinor analysis was 20%; the predicted value for a normal girl of this age is 4% and the 95% confidence interval is 0-8%. Treatment with propantheline, in a dose sufficient to reduce the amplitude of sinus arrhythmia to normal, abolished her symptoms.
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