12/12/2023 0 Comments Atropine on junctional escape rhythm![]() ![]() Also a coronary angiogram revealed no significant coronary artery disease. Cardiac echogram revealed no structural heart disease. Moreover, PVCs were “non-efficient” hemodynamically yielding a radial pulse estimated at ~30 bpm. Electrocardiogram and electrical monitoring showed sinus rhythm with persistent ventricular hyperexcitability in the form of ventricular bigeminy: monomorphic PVC with fixed coupling interval and fixed post-PVC cycle length ( Fig. Physical examination showed irregular heart beats, and carotid sinus massage was negative. The patient has given his consent for publication of his medical information in this case report.Ī 78-year-old male patient presented with repetitive fainting episodes. The appearance of accelerated junctional rhythm is a paradoxical effect of atropine, and discussion was made according to the literature data. In this paper, we present a symptomatic patient with a concealed form of SND, in whom atropine testing yielded a junctional rhythm with a nearly total disappearance of premature ventricular complexes (PVCs). Pharmacological autonomic blockage is sometimes used to unmask a concealed form of SND, also it may help to distinguish between intrinsic and extrinsic forms of SND. In this context, the appearance of ventricular hyperexcitability is often a bradycardia-induced arrhythmia, 1 and it may mask the classical electrocardiographical presentation of SND (concealed SND). Standard and long-term electrocardiographical recording may exhibit persistent bradycardia, alternating bradycardia–tachycardia, sinus pauses, or sinus arrest. It may present with different clinical and electrocardiographical forms. ![]() Sinus node dysfunction (SND) is a relatively common cardiac condition in the elderly.
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