Olgun H, Ceviz N, Karagoz T
Ataturk Universitesi, Tıp Fakültesi, Yakutiye Araştırma Hastanesi, Çocuk Kardiyoloji Polk, 25240 Erzurum, Turkey.
Divison of Pediatric Cardiology, Ataturk University, Faculty of Medicine, Erzurum, Turkey.
West Indian Med J. 2015 Jun;64(3):275-8. doi: 10.7727/wimj.2013.199. Epub 2015 Mar 12.
Paroxysmal atrioventricular block (PAVB) is a rare cause of syncope, mostly reported in adults. In the present study, a child with recurrent syncope due to PAVB is reported. A 12-year old boy was admitted due to syncope. Some syncopal episodes were consistent with vasovagal syncope, while others had atypical features. Electrocardiography, echocardiography and 24-hour electrocardiography monitoring were normal. Head-up tilt table test revealed mixed type vasovagal syncope. With beta-blocker treatment, the frequency of syncopal episodes decreased; however, the episodes with atypical features continued. Intracardiac electrophysiological study was normal, but repeated external loop recorder monitoring revealed transient AVB during a syncopal episode. In children with syncope with atypical features, PAVB should be kept in mind. Repeated external loop recorder monitoring may be useful in the diagnosis of such seldom seen arrhythmic causes.
阵发性房室传导阻滞（PAVB）是晕厥的罕见原因，多见于成人。本研究报告了一名因PAVB反复晕厥的儿童。一名12岁男孩因晕厥入院。部分晕厥发作符合血管迷走性晕厥，而其他发作具有非典型特征。心电图、超声心动图及24小时心电图监测均正常。直立倾斜试验显示为混合型血管迷走性晕厥。使用β受体阻滞剂治疗后，晕厥发作频率降低；然而，具有非典型特征的发作仍持续存在。心内电生理检查正常，但反复的体外循环记录仪监测显示在一次晕厥发作期间出现短暂房室传导阻滞。对于具有非典型特征晕厥的儿童，应考虑PAVB。反复的体外循环记录仪监测可能有助于诊断此类罕见的心律失常病因。
