Neurally Mediated Syncope Manifesting During Atrial Fibrillation A Case Report

Takeshi Shirayama; Keiji Inoue; Takashi Sakamoto; Midori Yamamura; Hiroki Mani; Akiko Yoshida; Hiroto Imai; Yayoi Matoba; Masao Nakagawa

doi:10.1253/circj.66.866

Case Report

Neurally Mediated Syncope Manifesting During Atrial Fibrillation

A Case Report

Takeshi Shirayama, Keiji Inoue, Takashi Sakamoto, Midori Yamamura, Hiroki Mani, Akiko Yoshida, Hiroto Imai, Yayoi Matoba, Masao Nakagawa

Author information

Takeshi Shirayama
Kyoto Prefectural University of Medicine, Second Department of Medicine
Keiji Inoue
Kyoto Prefectural University of Medicine, Second Department of Medicine
Takashi Sakamoto
Kyoto Prefectural University of Medicine, Second Department of Medicine
Midori Yamamura
Kyoto Prefectural University of Medicine, Second Department of Medicine
Hiroki Mani
Kyoto Prefectural University of Medicine, Second Department of Medicine
Akiko Yoshida
Kyoto Prefectural University of Medicine, Second Department of Medicine
Hiroto Imai
Kyoto Prefectural University of Medicine, Second Department of Medicine
Yayoi Matoba
Kyoto Prefectural University of Medicine, Second Department of Medicine
Masao Nakagawa
Kyoto Prefectural University of Medicine, Second Department of Medicine

Keywords: Atrial fibrillation, Head-up tilt, Neurally mediated syncope, Vagal nerve

JOURNAL FREE ACCESS

2002 Volume 66 Issue 9 Pages 866-868

DOI https://doi.org/10.1253/circj.66.866

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Abstract

A 64-year-old male was admitted to hospital because of repeated episodes of syncope and palpitation. Ambulatory monitoring revealed paroxysmal atrial fibrillation (AF) as the cause of palpitation; he did not have structural heart disease. The induction of AF by rapid pacing (50 Hz for 1 s) in an upright position provoked syncope with a vasodepressor response. Atropine sulfate blocked the induction of syncope. The possible etiology was neurally mediated syncope that manifested only during AF, which suggests that the abnormal vagal activity during AF in this case exaggerated the vasodepessor response while upright. (Circ J 2002; 66: 866 - 868)

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