Syncope electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Generally, the ECG of individuals with syncope is normal. However, ECG may be remarkable for an arrhythmia. The arrhythmia may be seen on the EKG include sinus bradycardia <40 beats/min or repetitive sinoatrial blocks or sinus pauses > 3s, Mobitz II 2nd or 3rd-degree atrioventricular block, alternating left and right bundle branch block, rapid paroxysmal supraventricular tachycardia, ventricular tachycardia, and pacemaker malfunction with cardiac pauses.
Electrocardiogram
Generally, the ECG of individuals with syncope is normal. However, ECG may be remarkable for an arrhythmia. The following arrhythmia may be seen on the EKG:[1]
- Sinus bradycardia <40 beats/min or repetitive sinoatrial blocks or sinus pauses > 3s
- Mobitz II 2nd or 3rd-degree atrioventricular block
- Alternating left and right bundle branch block
- Rapid paroxysmal supraventricular tachycardia
- Ventricular tachycardia
- Pacemaker malfunction with cardiac pauses
An ECG may be helpful in the diagnosis of syncope. Findings on an ECG suggestive of cardiovascular syncope include:
Example
Shown below is an EKG of an elderly man with syncope.
2006 ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) [2]
Guidelines
Electrophysiological Testing in Patients With Syncope
| Class I |
| "1. EP testing is recommended in patients with syncope of unknown cause with impaired LV function or structural heart disease. (Level of Evidence: B)" |
| Class IIa |
| "1. EP testing can be useful in patients with syncope when bradyarrhythmias or tachyarrhythmias are suspected and in whom noninvasive diagnostic studies are not conclusive. (Level of Evidence: B)" |
References
- ↑ "Guidelines on Management (diagnosis and treatment) of syncope ? update 2004". Europace. 6 (6): 467–537. 2004. doi:10.1016/j.eupc.2004.08.008. ISSN 1099-5129.
- ↑ Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M; et al. (2006). "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (10): e385–484. doi:10.1161/CIRCULATIONAHA.106.178233. PMID 16935995.