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Concealed Sinus Node Dysfunction And Paradoxical Effect Of Atropine During Arrhythmia Diagnostic Pharmacological Testing
Author: Myriam Karam, Antoine Kossaify
Publisher: Derivative Works
4 pages
One time payment: €0.00
Required subscription: Free
Type of publication: Article
ISBN/ISSN: 1179-5476
DOI: 10.4137/CCRep.S18122
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A 78-year-old male patient presented with repetitive fainting episodes. His electrocardiogram showed sinus rhythm with persistent ventricular bigeminy. Concealed sinus node dysfunction (SND) with consecutive bradycardia-induced ventricular hyperexcitability was suspected. Pharmacological testing with atropine resulted in accelerated junctional rhythm along with nearly total disappearance of the ventricular ectopy. The diagnosis of SND was retained, a dual chamber pacemaker was implanted, and consequently, ventricular hyperexcitability disappeared. The junctional rhythm was a paradoxical effect of atropine, and many explanations were provided. Discussion was made accordingly taking into account relevant data from the literature.

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