Seizure Triggered by Sick Sinus Syndrome

Sick sinus syndrome (SSS) is a dysfunction of sinoatrial node resulting in symptomatic bradycardia or sinus pauses causing decreased cardiac output with cerebral hypoperfusion and usually presents as syncope, presyncope or fatigue. The occurrence of a seizure is very rare. A 69-year-old man suffered two episodes of generalised tonic–clonic seizures. MRI and electroencephalogram failed to reveal the cause of seizures. In the emergency room, he experienced presyncope simultaneous to bradycardia and sinus pauses. He was stabilised with atropine and dopamine infusion and underwent definitive therapy with a permanent dual-chamber pacemaker with complete symptom resolution. Diagnostic confounders include convulsive syncope and ictal bradycardia. Syncope may be accompanied by myoclonic jerks (convulsive syncope), but postictal confusion is absent. Bradycardia may be seen during the postictal period (ictal bradycardia syndrome), but protracted sinus dysfunction is not present. Hypoperfusion due to significant SSS triggered seizures in this patient who may have an underlying predisposition.

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Rare Case of Rapidly Worsening REM Sleep Induced Bradycardia

Case Reports in Cardiology ◽

10.1155/2015/546712 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ayyappa S. Duba ◽

Suneetha Jasty ◽

Ankit Mahajan ◽

Vijay Kodadhala ◽

Raza Khan ◽

...

Keyword(s):

Rem Sleep ◽

Rare Case ◽

Sinoatrial Node ◽

Past Medical History ◽

Sinus Arrest ◽

Dual Chamber ◽

Significant Past Medical History ◽

Sleep Study ◽

Dual Chamber Pacemaker ◽

Over Time

Sinoatrial arrest also known as sinus pause occurs when sinoatrial node of the heart transiently ceases to generate the electrical impulse necessary for the myocardium to contract. It may last from 2.0 seconds to several minutes. Etiologies of sinoatrial arrest can be complex and heterogeneous. During rapid eye movement (REM) sleep, sinus arrests unrelated to apnea or hypopnea are very rare and only a few cases have been reported. Here we report a case of 36-year-old male with no significant past medical history who presented to our hospital after a syncopal episode at night. Physical examination showed no cardiac or neurological abnormalities and initial EKG and neuroimaging were normal. Overnight telemonitor recorded several episodes of bradyarrhythmia with sinus arrest that progressively lengthened over time. Sleep study was done which confirmed that sinus arrests occurred more during REM sleep and are unrelated to apnea or hypopnea. Electrophysiology studies showed sinus nodal dysfunction with no junctional escape, subsequently a dual chamber pacemaker placed for rapidly worsening case of REM sleep induced bradycardia.

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Gastric Dysrhythmia Corrected by Dual Chamber Pacemaker Implantation

International Cardiovascular Forum Journal ◽

10.17987/icfj.v13i0.492 ◽

2018 ◽

Vol 13 ◽

Author(s):

Marcio Galindo Kiuchi

Keyword(s):

Nervous System ◽

Pacemaker Implantation ◽

Endocrine System ◽

Subjective Feeling ◽

Dual Chamber ◽

Severe Nausea ◽

Dual Chamber Pacemaker ◽

Psychological States ◽

Underlying Mechanisms ◽

Sinus Dysfunction

HighlightsNausea has been defined as an “unpleasant painless subjective feeling that one will imminently vomit”. While nausea and vomiting are often thought to exist on a temporal continuum, this is not always the case. There are situations when severe nausea may be present without emesis and less frequently, when emesis may be present without preceding nausea. The underlying mechanisms involved in nausea are complex and encompass psychological states, the central nervous system, autonomic nervous system, gastric dysrhythmias, and the endocrine system. We report a 92-year-old male patient with depression, hypothyroidism, and intermittent severe sinus dysfunction, causing nausea, vomiting, and fatigue, pre-syncope and low cerebral output. Dual chamber implantation was performed and 24 hours after the implantation of the device all the symptoms disappeared, the parameters of the pacemaker were stable, and the patient was discharged. At the 1st and the 3rd month after implantation the patient remained asymptomatic. Over-activity of autonomic outflow may be a determinant for overall nausea intensity, probably, may be a potential therapeutic target to be corrected, at least in part, by a dual chamber pacemaker implantation.

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PERSISTANT LEFT SUPERIOR VENA CAVA IN A PATIENT WITH AN IMPLANTED DUAL CHAMBERPASING SYSTEM

Clinical Practice ◽

10.17816/clinpract6224-26 ◽

2015 ◽

Vol 6 (2) ◽

pp. 24-26

Author(s):

A A Kocharyan ◽

R S Ovchinnikov ◽

V N Lesniak ◽

A V Ardashev

Keyword(s):

Superior Vena Cava ◽

Clinical Case ◽

Sick Sinus Syndrome ◽

Superior Vena ◽

Vena Cava ◽

Dual Chamber ◽

Left Superior Vena Cava ◽

Dual Chamber Pacemaker

We described a clinical case of a 65-years patient with sick sinus syndrome with persistant left superior vena cava, whom was implanted dual chamber pacemaker.

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Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

Vojnosanitetski pregled ◽

10.2298/vsp0504329r ◽

2005 ◽

Vol 62 (4) ◽

pp. 329-334

Author(s):

Goran Radjen ◽

Sasa Rafajlovski ◽

Zoran Perisic ◽

Radoslav Romanovic

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Antiarrhythmic Drugs ◽

Atrial Pacing ◽

Cardiac Dysrhythmia ◽

Dual Chamber ◽

Short Term ◽

Dual Chamber Pacemaker ◽

Symptomatic Bradycardia ◽

High Level

Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI). Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short ? term episodes of atrial fibrillation, and a high level of atrial pacing (99%). Conclusion. In selected patients with bradycardia?tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.

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