ABSTRACT
We used the P-wave signal-averaged electrocardiogram (SAECG) prospectively in 93 healthy volunteers of different ages and observed: (1) a positive correlation between P-wave duration on the SAECG and age (r = 0.39, p < 0.0001); and (2) the proportion of subjects with prolonged P-wave duration was increased with older age. These findings confirm the hypothesis that age-related atrial conduction delay in healthy subjects is present, and detectable by the P-wave SAECG.
Subject(s)
Aging/physiology , Atrial Function , Electrocardiography , Heart Conduction System/growth & development , Heart Rate/physiology , Adult , Aged , Aged, 80 and over , Atrial Fibrillation/etiology , Atrial Fibrillation/physiopathology , Female , Humans , Male , Middle Aged , Prospective Studies , Reference Values , Risk FactorsABSTRACT
We describe the cases of 2 patients with repetitive episodes of syncope with profound bradycardia and hypotension. In both patients, the symptoms were initially thought to be neurally mediated and idiopathic but were ultimately determined to be triggered by serious underlying pathologic processes: a massive and locally invasive tumor of the hypopharynx in 1 patient and a gangrenous gallbladder in the other. Appropriate treatment resulted in a resolution of this syndrome in both patients. These cases emphasize the importance of an appropriate evaluation and broad differential diagnoses for patients with severe bradycardia and hypotension.
