Incidental Findings of Asystole in a Patient With Complaints of Near Syncope: A Case Report on Paroxysmal Ventricular Standstill

Paroxysmal ventricular standstill (PVS) is an unusual cardiac phenomenon in which the heart experiences episodes of absent ventricular activity despite normal atrial functioning, often leading to cardiac arrest and syncope. In this case, we report the hospital stay of a 70-year-old male who was admi...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2021-10, Vol.13 (10)
Main Authors: Moles, William J, Barnes, Anne A, Khan, Ahmed, Patel, Kashyap, Bos, Nadine
Format: Article
Language:English
Subjects:
Cardiac arrhythmia
Cardiac stress tests
Cardiology
Cardiovascular disease
Case reports
Coronary vessels
Diabetes
Electrocardiography
Fainting
Heart rate
Internal Medicine
Medicine
Pacemakers
Telemetry
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Summary:Paroxysmal ventricular standstill (PVS) is an unusual cardiac phenomenon in which the heart experiences episodes of absent ventricular activity despite normal atrial functioning, often leading to cardiac arrest and syncope. In this case, we report the hospital stay of a 70-year-old male who was admitted to the hospital following an episode of near syncope at home. On admission, the patient’s initial electrocardiogram (ECG) showed sinus rhythm at 60 beats per minute without atrioventricular (AV) block. However, as orthostatic vitals were obtained, the patient became lightheaded for several seconds upon standing, which was noted to correspond with a nine second episode of asystole on telemetry and spontaneous return to sinus bradycardia afterward. Cardiology was immediately consulted and confirmed the diagnosis of paroxysmal ventricular standstill (PVS). Given continued episodes of PVS, the patient underwent successful urgent dual-chamber pacemaker placement, following which he became asymptomatic with resolution of bradycardia. Given the high mortality risk associated with PVS, this condition is an important differential to consider in any patient presenting with syncope or near syncope of unclear etiology.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.18438