HRDx Case Study #6
HRDx Case Study #6
- A 52-year-old man presented with recurrent palpitations and dyspnea. Ambulatory cardiac monitoring was
performed. - A notification for a 4.0-second pause was sent to the ordering provider. The patient underwent implantation of dualchamber pacemaker, which later was complicated by pacemaker pocket infection requiring device
HRDx Case Study #6
- Review of rhythm data by HRDx cardiac electrophysiologists identified the benign nature of sinus pauses. All pauses
occurred during sleep and were asymptomatic, indicative of increased vagal tone as the cause of pauses. - After pacemaker explantation, implantation of a new pacemaker system was not recommended, and the patient was
reassured given the benign nature of the observed pauses.
HRDx Case Study #6
- Two patients with history of recurrent presyncope underwent mobile cardiac telemetry.
- In both patients, ventricular pause secondary to advanced AV block were identified.
HRDx Case Study #6
- Review of rhythm data by HRDx cardiac electrophysiologists identified the benign nature of AV block in the first
patient, as indicated by occurrence of the block during sleeping and the concomitant slowing of sinus P waves,
consistent with increased vagal tone, which does not require pacemaker implantation. - In contrast, AV block in the second patient occurred while awake and was associated with acceleration of the sinus
rate, consistent with pathological paroxysmal AV block, which necessitates pacemaker implantation