Pre-syncope In An ICD Patient: An Unexpected Aetiology
West Suffolk NHS Foundation Trust, UK
Disclosure: The author has no conflict of interests to declare.
This case was co-published with the Arrhythmia Academy Radcliffe site.
A 65-year-old male was admitted to the coronary care unit following multiple episodes of pre-syncope. He had a history of symptomatic beta-blocker induced sinus bradycardia, a marked first-degree AV block and an idiopathic VF arrest, for which a dual-chamber ICD was implanted in 2016.
Device interrogation was performed to ascertain the cause of his pre-syncope.
There were no monitored or treated ventricular arrhythmias. All battery and lead measurements were within normal limits.
The only stored EGMs since the last follow-up were RYTHMIQ episodes. An EGM which correlated with the patient’s most recent pre-syncopal episode is shown below in Figure 1.
Figure 1: A RYTHMIQ EGM recorded by the device at the time of documented pre-syncope