A Case of Prolonged Asystole During Head-up Tilt Testing

Öz

Head-up tilt test is used for evaluating patients with neurocardiogenic syncope (NCS) and syncope of unknown etiology. A 31-year-old woman was examined for three syncopal episodes during the past two months, all of which preceded by nausea and sweating. Examinations including electrocardiography and echocardiography showed normal findings. A head-up tilt table testing was performed at an angle of 60 degrees. At about 8 minutes, syncope associated with bradycardia and asystole was observed. She became hypotensive, and there was a ventricular asystolic pause lasting 20 seconds, associated with loss of consciousness. She was placed in the supine position and cardiac massage was started. After 20 seconds, she slowly returned to sinus rhythm and regained consciousness. The patient was treated with dual-chamber (DDD-R) pacemaker implantation. During six months of follow-up, no major events occurred.

Anahtar Kelimeler

• Head-up tilt test, vasovagal syncope, asystole

Tilt Testi Sırasında Aşırı Uzamış Asistol

Öz

Tilt testi nörokardiyojenik senkoplu hastalarda kullanılan bir yöntemdir. 31 yaşında kadın hasta, son iki aydır bulantı ve terlemeyi takiben ortaya çıkan üç senkop atağı nedeniyle kardiyolojik açıdan incelendi. Hastanın elektrokardiyografi ve ekokardiyografi de dahil tüm sistem incelemeleri normal bulundu. Bunun üzerine, hastaya eğimi 60 dereceye ayarlanan tilt testi uygulandı. Testin yaklaşık 8. dakikasında hastada bradikardi ve asistolün eşlik ettiği senkop gelişti. Hipotansiyonla birlikte 20 saniye süren ventriküler asistol ve bilinç kaybı görülmesi üzerine hasta sırtüstü pozisyonda yatırıldı ve kalp mesajına başlandı. Yaklaşık 20 saniye sonra hasta yavaş yavaş sinüs ritmine döndü ve ardından bilinci yerine geldi. Tedavi olarak hastaya iki odacıklı kalp pili takıldı. Bir yıllık izlemi içinde hastanın semptomlarında herhangi bir tekrarlama olmadı

Anahtar Kelimeler

• Tilt testi, vazovagal senkop, asistoli

Kaynakça

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