An atypical case of vagally mediated atrial fibrillation in an elderly woman: electrocardiographic caveats to diagnosis

Chenni S Sriram; Gerald V Naccarelli; Jerry C Luck

doi:10.1016/j.jelectrocard.2014.07.007

An atypical case of vagally mediated atrial fibrillation in an elderly woman: electrocardiographic caveats to diagnosis

J Electrocardiol. 2014 Sep-Oct;47(5):734-7. doi: 10.1016/j.jelectrocard.2014.07.007. Epub 2014 Jul 8.

Authors

Chenni S Sriram¹, Gerald V Naccarelli¹, Jerry C Luck²

Affiliations

¹ Division of Electrophysiology, Heart & Vascular Institute, Penn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA.
² Division of Electrophysiology, Heart & Vascular Institute, Penn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA. Electronic address: jluck@hmc.psu.edu.

PMID: 25060130
DOI: 10.1016/j.jelectrocard.2014.07.007

Abstract

Vagally mediated paroxysmal atrial fibrillation is typically described to occur in otherwise healthy young-to-middle aged males during periods of high vagal tone. We report a case of cardioinhibitory type neurocardiogenic syncope associated with atrial fibrillation in an elderly female during episodes of nausea. This was replicated during tilt-table testing. The atrial fibrillation was part of a unique snap shot of the entire electrophysiological spectrum of the vagal response captured in detail in this index patient.

Keywords: Complete atrioventicular block; Syncope; Vagally mediated atrial fibrillation.

Publication types

Case Reports

MeSH terms

Aged
Atrial Fibrillation / diagnosis*
Atrial Fibrillation / physiopathology*
Electrocardiography*
Female
Humans
Recurrence
Syncope, Vasovagal / diagnosis*
Syncope, Vasovagal / physiopathology*
Tilt-Table Test