Journal Article

The pattern of activation of the sympathetic nervous system during tilt-induced syncope

Dorota Zyśko, Jacek Gajek, Ryszard Ściborski, Jacek Smereka, Igor Chęciński and Walentyna Mazurek

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 4, pages 225-227
Published in print April 2007 | ISSN: 1099-5129
Published online March 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum027
The pattern of activation of the sympathetic nervous system during tilt-induced syncope

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A 49-year-old patient with a history of situational syncope and minimal electrocardiographic signs of accessory pathway is described. The evidence for pre-excitation was present only during the sympathetic activation caused by exercise testing and isoprenaline infusion. This phenomenon served as an indicator of significant adrenergic drive to the heart after the tilt-induced syncope.

The meaning of the observed electrocardiographic changes in the course of neurocardiogenic reaction and its contribution to the understanding of the sympatho-vagal balance during vasovagal syncope is discussed. The lack of preexcitation signs during syncope and its appearance several seconds after the syncope-related sinus pause indicates sympathetic withdrawal before and shortly after the asystole. The possible pathophysiological mechanisms are discussed.

Keywords: Autonomic nervous system; Tilt testing; Vasovagal syncope

Journal Article.  1465 words.  Illustrated.

Subjects: Cardiovascular Medicine

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