Abstract
A patient wished that the Holter electrocardiogram be detached. However, with the extension of recording, we detected a paroxysmal atrioventricular block. We encountered the case of a patient that showed the importance of elucidating subjective symptoms before detaching the device. The patient was a 78-year-old female, who was conscious about two weeks previously. However, her consciousness level gradually decreased. We performed an emergency outpatient examination. Head CT showed no abnormality. An abnormality in liver function was confirmed by a blood test. A close examination of the cause of consciousness loss due to a seizure became necessary. After fitting a Holter electrocardiogram for precise examination, the patient was introduced to a gastroenterologist the following day. We visited the patient the following morning. The patient requested that the Holter electrocardiogram be removed before seeing her gastroenterologist. There were no subjective symptoms after a recording of 16 hours. After examining the patient and consulting with her gastroenterologist, it was decided that the Holter electrocardiogram be removed. A seizure occurred while she was waiting for her consultation and she became unconscious. At the time of her seizure, a paroxysmal atrioventricular block appeared. The patient showed no signs of cardiac arrest about 2 seconds or more before the Holter electrocardiogram was removed. The patient was accurately diagnosed when the Holter electrocardiographic measurement was resumed. Patients who require elucidation of their subjective symptoms should undergo recording for as long as possible until the subjective symptoms are detected.
