Medtronic
 
 

Insertable
Cardiac Monitor

Syncopal Fall and Bradycardia Followed by Sinus Arrest


BACKGROUND

An 83-year-old woman presented at the ER following her first syncopal event. During the event, the patient fell against a radiator in her home. An examination showed:

  • Third degree burns to her upper extremities and
  • Tendon damage to her right hand

Her history revealed:

  • Significant hypothyroidism
  • Angina upon exertion
  • 40% carotid stenosis on the right side

The patient’s workup for syncope included numerous diagnostic tests. However, all studies proved to be non-diagnostic and she was released from the hospital after recuperating from her burns.

Over the next two years, the patient continued to experience additional unexplained syncopal episodes. Her syncope:

  • Threatened her independence
  • Forced the family to consider moving her to an elder care facility

To avoid moving to an elder care facility, they began an aggressive search for a diagnosis.

WORKUP

While seeing an electrophysiciologist, the patient underwent extensive testing including

  • Holter monitor
  • ECGs
  • Echo
  • Reveal ILR implant

CONCLUSION

Within six months the Reveal recorded an episode that yielded a diagnosis:

  • The ECG from the Reveal showed a marked slowing in the heart rate, followed by eight seconds of sinus arrest (as shown below)


Source: University of Western Ontario University Hospital, London, Ontario, Canada

  • A pacemaker was implanted
  • The patient continues to live independently

Data on file at Medtronic, Inc. Results may not be typical for every patient.

Additional Information