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Psychogenic Syncope? A Cautionary Note
Author(s) -
KANJWAL KHALIL,
KANJWAL YOUSUF,
KARABIN BEVERLY,
GRUBB BLAIR P.
Publication year - 2009
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02400.x
Subject(s) - asystole , medicine , psychogenic disease , syncope (phonology) , etiology , implantable loop recorder , cardiology , anesthesia , atrial fibrillation , psychiatry
In some patients with recurrent syncope, the etiology may remain unclear despite extensive evaluation. These patients may sometimes be labeled as having a “psychogenic” cause for their syncope.Methods: We report on three patients with recurrent unexplained syncope (despite extensive evaluation) who were labeled as having a psychogenic cause for their events. In each patient following placement of an implantable loop recorder, their syncopal events were found to be due to periods of prolonged asystole and/or complete heart block. One patient had prolonged asystole for 44 seconds. In each patient, episodes of syncope were eliminated following permanent pacemaker implantation.Conclusion: We conclude that physicians should exercise great caution before labeling any patient's syncope as psychogenic and that prolonged monitoring may be necessary to exclude a potential cardiac rhythm‐related etiology.