Transient Atrioventricular Standstill: Title and subTitle BreakEtiology and Management FREE

Prem K. Gupta, MD, FRCP(C); Edgar Lichstein, MD; Kul D. Chadda, MD

[+] Author Affiliations

Reprint requests to Division of Cardiology, Mount Sinai Hospital Services, City Hospital Center at Elmhurst, 79-01 Broadway, Elmhurst, NY 11373 (Dr. Gupta).

JAMA. 1975;234(10):1038-1042. doi:10.1001/jama.1975.03260230038020

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ABSTRACT

ABSTRACT | REFERENCES

Four patients with different clinical conditions had transient cardiac standstill for periods of up to 22.5 seconds. All patients showed signs of cerebral ischemia and required cardiac resuscitation. In one patient, the standstill was thought to be the result of a transient increase in the vagal tone, and no long-term therapy was required. In the second patient, cardiac standstill occurred during hospitalization for impending myocardial infarction. Coronary arteriography followed by coronary artery surgery was performed, and there were no further episodes of standstill. In the third patient, standstill was probably related to long-term ingestion of propranolol hydrochloride, and was not observed after this medication was discontinued. In the fourth patient, standstill was the result of the sick sinus syndrome, and a permanent pacemaker was inserted. Standstill of both atria and ventricles may occur under different clinical settings, and management of arrhythmia should be guided by the etiology of the arrhythmia.

(JAMA 234:1038-1042, 1975)

REFERENCES

ABSTRACT | REFERENCES

Schwartz SP, Schwartz LS: Mechanisms of Adams-Stokes seizures , in Dreifus LS, Likoff W (eds): Mechanisms and Therapy of Cardiac Arrhythmias . New York, Grune & Stratton Inc, 1966;, pp 477-486.

Tuna N, Scott JW: Stokes-Adams attacks with simultaneous auricular and ventricular standstill . Circulation 9:853-856, 1954;.

Wedd AM, Wilson DC: Standstill of the heart of vagal origin . Am Heart J 5:493-503, 1930;.

Wenger MA, Bagchi BK, Anand BK: Experiments in India on "voluntary" control of the heart and pulse . Circulation 24:1319-1325, 1961;.

Paull AM, Pecora DV, Cooper P, et al: Bradycardia and syncope as early manifestations of bronchogenic carcinoma . N Engl J Med 248:773-775, 1953;.

Levy MN, Ng M, Lipman RI, et al: Vagus nerves and baroreceptor control of ventricular performance . Circ Res 18:101-106, 1966;.

Wildenthal K, Mierzwiak DS, Wyatt HL, et al: Influence of efferent vagal stimulation on left ventricular function in dogs . Am J Physiol 216:577-581, 1969;.

Bianco JA, Freedberg LE, Powell WJ Jr, et al: Influence of vagal stimulation on ventricular compliance . Am J Physiol 218:264-269, 1970;.

De Geest H, Levy MN, Zieskie H: Negative inotropic effect of the vagus nerves upon the canine ventricle . Science 144:1223-1225, 1964;.

Jacobowitz D, Cooper T, Barner H: Histochemical and chemical studies of the localization of adrenergic and cholinergic nerves in the normal and denervated cat hearts . Circ Res 20:289-297, 1967;.

Hirsch EF, Kaiser GC, Cooper T: Experimental heart block in dog: III. Distribution of the vagus and sympathetic nerves in the septum . Arch Pathol 79:441-451, 1965;.

Napolitano LM, Willman VL, Hanlon CR, et al: Intrinsic innervation of the heart . Am J Physiol 208:455-458, 1965;.

Vassalle M, Caress DL, Slovin AJ, et al: On the causes of ventricular asystole during vagal stimulation . Circ Res 20:228-241, 1967;.

Greenwood WF, Cooper WE, Bayley TA: Adams-Stokes attacks due to atrial and ventricular arrest, treated by vagotomy . Circulation 21:1140-1146, 1960;.

Rokseth R, Hatle L: Sinus arrest in acute myocardial infarction . Br Heart J 33:639-642, 1971;.

Lippestad CT, Marton PF: Sinus arrest in proximal right coronary artery occlusion . Am Heart J 74:551-556, 1967;.

James TN: Anatomy of the Coronary Arteries . New York, Paul B Hoeber Inc, 1961;, p 104.

Lippestad CT, Forfang K: Production of sinus arrest by lignocaine . Br Med J 1:537, 1971;.

Scheinman MM, Weiss AN, Shafton E, et al: Electrophysiologic effects of procainamide in patients with intraventricular conduction delay . Circulation 49:522-529, 1974;.

Ferrer MI: The sick sinus syndrome . Circulation 47:635-641, 1973;.

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