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Dizziness and near syncope due to sinus bradycardia and sinoatrial block associated with obesity and daytime tiredness. A clear indication for pacemaker implantation?
- Source :
-
Herz [Herz] 2008 Sep; Vol. 33 (6), pp. 455-9. Date of Electronic Publication: 2009 Jan 21. - Publication Year :
- 2008
-
Abstract
- Background: The symptomatic sick sinus syndrome presents a classic indication for the implantation of a dual-chamber pacemaker according to the current national and international guidelines. However, in cases where dizziness and near syncope due to a sinus node dysfunction are found together with clinical characteristics of a sleep apnea-hypopnea syndrome (SAHS), screening for sleep apnea would be prudent before deciding for a pacemaker.<br />Case Study: The case report presented herein describes a patient with symptomatic sinus bradycardia and second-degree SA block with a Wenckebach periodicity, in whom the primary decision to implant a pacemaker was altered in favor of treatment with nCPAP (nasal continuous positive airway pressure) because after a careful and thorough evaluation of the patient's history and symptoms, a severe mixed SAHS was diagnosed.<br />Conclusion: On diagnosing SAHS with an obstructive component in patients with symptomatic bradycardia and SA block, there is no primary need for a pacemaker, but rather for implementing treatment with nCPAP. Thus, a pacemaker should only be considered in patients with intolerance or bad compliance regarding nCPAP, or in those in whom no significant reduction of bradyarrhythmia is achieved.
- Subjects :
- Bradycardia prevention & control
Dizziness prevention & control
Fatigue prevention & control
Humans
Male
Middle Aged
Obesity prevention & control
Pacemaker, Artificial
Patient Selection
Sinoatrial Block prevention & control
Sleep Apnea, Obstructive prevention & control
Syncope prevention & control
Treatment Outcome
Bradycardia complications
Continuous Positive Airway Pressure
Dizziness etiology
Fatigue etiology
Obesity complications
Sinoatrial Block complications
Sleep Apnea, Obstructive complications
Syncope etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1615-6692
- Volume :
- 33
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Herz
- Publication Type :
- Academic Journal
- Accession number :
- 19156381
- Full Text :
- https://doi.org/10.1007/s00059-008-3096-2