Syncope Due to Idiopathic Paroxysmal Atrioventricular Block
Open accessAbstract
Objectives We present data on patients with syncope due to paroxysmal atrioventricular (AV) block unexplainable in terms of currently known mechanisms.Background Paroxysmal AV block is known to be due to intrinsic AV conduction disease or to heightened vagal tone.Methods We evaluated 18 patients presenting with unexplained syncope who had: 1) normal baseline standard electrocardiogram (ECG); 2) absence of structural heart disease; and 3) documentation, by means of prolonged ECG monitoring at the time of syncopal relapse, of paroxysmal third-degree AV block with abrupt onset and absence of other rhythm disturbances before or during the block.Results The study group consisted of 9 men and 9 women, mean age 55 ± 19 years, who had recurrent unexplained syncope for 8 ± 7 years and were subsequently followed up for as long as 14 years (4 ± 4 years on average). The patients had no structural heart disease, standard ECG was normal, and electrophysiological study was negative. In all patients, prolonged ECG monitoring documented paroxysmal complete AV block with 1 or multiple consecutive pauses (mean longest pause: 9 ± 7 s at the time of syncope); AV block occurred without P-P cycle lengthening or PR interval prolongation. During the observation time, no patient had permanent AV block; on permanent cardiac pacing, no patient had further syncopal recurrences.Conclusions Common clinical and electrophysiological features define a distinct form of syncope due to idiopathic paroxysmal AV block characterized by a long history of recurrent syncope, absence of progression to persistent forms of AV block, and efficacy of cardiac pacing therapy.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with idiopathic AV block had an otherwise normal heart and no sign of conduction disease on ECG and EPS; they had very low plasma adenosine levels and a high induction rate of transient complete heart block during exogenous injections of adenosine.
“These patients had an otherwise normal heart and no sign of conduction disease on ECG and EPS; they had very low plasma adenosine levels and a high induction rate of transient complete heart block during exogenous injections of adenosine.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [5]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredCardiac pacing effectively prevents syncopal recurrences in this syndrome.
“Cardiac pacing effectively prevents syncopal recurrences.112,139,140”
No syncope recurrence was observed after permanent cardiac pacing over very long periods of follow-up in patients with idiopathic AV block, and there was no permanent AV block.
“No syncope recurrence was observed after permanent cardiac pacing over very long periods of follow-up and there was no permanent AV block.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [5]
A new clinical entity, idiopathic AV block, has been described in patients with a long history of syncope and in whom paroxysmal AV block could be recorded at the time of syncope recurrence.
“A new clinical entity, called idiopathic AV block, has recently been described in patients with a long history of syncope and in whom paroxysmal AV block could be recorded at the time of syncope recurrence. 5”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [5]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040 · see citing works
Self-citationShryock, J. C., & Belardinelli, L. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00256-7 · Cited by 578 · see citing works
Cardiac electrophysiology of adenosine. Basic and clinical concepts.
Lerman, B. B., & Belardinelli, L. (1991) · Circulation · doi:10.1161/01.cir.83.5.1499 · Cited by 377 · see citing works
Brignole, M., Sutton, R., Menozzi, C., Garcia-Civera, R., Moya, A., Wieling, W., Andresen, D., Benditt, D. G., & Vardas, P. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehi842 · Cited by 376 · see citing works
Self-citationParoxysmal atrioventricular block
Lee, S., Wellens, H. J. J., & Josephson, M. E. (2009) · Heart Rhythm · doi:10.1016/j.hrthm.2009.04.001 · Cited by 164 · see citing works
Brignole, M. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehl164 · Cited by 145 · see citing works
Self-citationClemo, H. F., & Belardinelli, L. (1986) · Circulation Research · doi:10.1161/01.res.59.4.427 · Cited by 126 · see citing works
An Implantable Loop Recorder Study of Highly Symptomatic Vasovagal Patients
Deharo, J.-C., Jego, C., Lanteaume, A., & Djiane, P. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.09.043 · Cited by 110 · see citing works
Self-citationBrignole, M., Moya‐Mitjans, À., Menozzi, C., García–Civera, R., & Sutton, R. (2005) · EP Europace · doi:10.1016/j.eupc.2004.11.001 · Cited by 106 · see citing works
Self-citationBrignole, M., Gaggioli, G., Menozzi, C., Gianfranchi, L., Bartoletti, A., Bottoni, N., Lolli, G., Oddone, D., Rosso, A. D., & Pellinghelli, G. (1997) · Circulation · doi:10.1161/01.cir.96.11.3921 · Cited by 98 · see citing works
Self-citationRole of Endogenous Adenosine as a Modulator of Syncope Induced During Tilt Testing
Saadjian, A., Lévy, S., Franceschi, F., Zouher, I., Paganelli, F. F., & Guieu, R. (2002) · Circulation · doi:10.1161/01.cir.0000023924.66889.4c · Cited by 90 · see citing works
Self-citationParoxysmal atrioventricular block: Are phase 3 and phase 4 block mechanisms or misnomers?
El‐Sherif, N., & Jalife, J. (2009) · Heart Rhythm · doi:10.1016/j.hrthm.2009.06.025 · Cited by 87 · see citing works
Role of Endothelial Dysfunction in Coronary Artery Disease
Abrams, J. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00379-2 · Cited by 76 · see citing works
Implications of mechanism of bradycardia on response to pacing in patients with unexplained syncope
Sud, S., Klein, G. J., Skanes, A. C., Gula, L. J., Yee, R., & Krahn, A. D. (2007) · EP Europace · doi:10.1093/europace/eum020 · Cited by 66 · see citing works
Strasberg, B., Lam, W., Swiryn, S., Bauernfeind, R. A., Scagliotti, D., Palileo, E. A., & Rosen, K. (1982) · American Heart Journal · doi:10.1016/0002-8703(82)90391-x · Cited by 56 · see citing works
Clinical features of adenosine sensitive syncope and tilt induced vasovagal syncope
Brignole, M. (2000) · Heart · doi:10.1136/heart.83.1.24 · Cited by 52 · see citing works
Self-citationA partial agonist of the A1-adenosine receptor selectively slows AV conduction in guinea pig hearts
Wu, L., Belardinelli, L., Zablocki, J. A., Palle, V. P., & Shryock, J. C. (2001) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.2001.280.1.h334 · Cited by 46 · see citing works
Head-up tilt induced syncope and adenosine A2A receptor gene polymorphism
Saadjian, A., Gérolami, V., Giorgi, R., Mercier, L., Bergé-Lefranc, J. L., Paganelli, F. F., Ibrahim, Z., By, Y., Guéant, J., Lévy, S., et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp126 · Cited by 44 · see citing works
Self-citationFLAMMANG, D., Erickson, M. K., McCarville, S., Church, T. R., Hamani, D., & Donal, E. (1999) · Circulation · doi:10.1161/01.cir.99.18.2427 · Cited by 38 · see citing works
Carrega, L., Saadjian, A., Mercier, L., Zouher, I., Bergé‐Lefranc, J., Gérolami, V., Giaime, P., Sbragia, P., Paganelli, F. F., Fenouillet, E., et al. (2007) · Heart Rhythm · doi:10.1016/j.hrthm.2007.03.002 · Cited by 32 · see citing works
Self-citationElectrocardiographic characteristics of atrioventricular block induced by tilt testing
Zyśko, D., Gajek, J. J., Koźluk, E., & Mazurek, W. (2008) · EP Europace · doi:10.1093/europace/eun299 · Cited by 30 · see citing works
Mendoza, I. J., Castellanos, A., Lopera, G., Moleiro, F., Mitrani, R. D., & Myerburg, R. J. (2000) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)00890-5 · Cited by 22 · see citing works
Perennes, A., Fatemi, M., Borel, M. L., Lebras, Y., L'Her, C., & Blanc, J. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.09.044 · Cited by 21 · see citing works
Sinus Tachycardia with Atrioventricular Block:
Sra, J. S., Singh, B. B., Blanck, Z., Dhala, A. A., & Akhtar, M. (1998) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1998.tb00901.x · Cited by 17 · see citing works
Accelerated sinus rhythm with high grade A-V block during head-up tilt testing
Paravolidakis, K. E., Apostolou, T. S., Theodorakis, G., Vartela, V., & Kremastinos, D. T. (2006) · EP Europace · doi:10.1093/europace/euj031 · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [16]16. Sanjua ´n R, Facila L, Blasco ML, Garcı ´a-Civera R, Ruiz Granell R, Morell Cabedo S. Case 13. Neuromediated syncope presenting as high grade AV block. In: Garcia-Civera R, Baron-Esquivias G, Blanc JJ, et al., editors. Syncope Cases. Oxford: Blackwell Futura, 2006:38 -40.
- [21]21. Burnstock G, Kennedy C. Purinergic receptors in the cardiovascular system. Prog Pharmacol 1986;6:111-32.
- [26]26. Moya A, Sutton R, Ammirati F, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009;30:2631-71.
Cited by
Sorted by citations
2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Authors Task Force Members, Brignole, M., Auricchio, A., Barón‐Esquivias, G., Bordachar, P., Boriani, G., Breithardt, O. A., Cleland, J. G. F., Deharo, J.-C., Delgado, V., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht150 · Cited by 2,824 · see citing works
Self-citation2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab364 · Cited by 2,019 · see citing works
Self-citation2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951 · see citing works
Self-citation2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Authors Task Force Members, Brignole, M., Auricchio, A., Barón‐Esquivias, G., Bordachar, P., Boriani, G., Breithardt, O. A., Cleland, J. G. F., Deharo, J., Delgado, V., et al. (2013) · EP Europace · doi:10.1093/europace/eut206 · Cited by 1,125 · see citing works
Self-citationSheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013 · see citing works
“Cardiac pacing effectively prevents syncopal recurrences.(112,139,140) In a small multicenter trial performed on 80 selected elderly patients with unexplained syncope, dual-chamber cardiac pacing significantly reduced 2-year syncopal recurrence from 69% in the control group to 23% in the active group.”
BackgroundSelf-citationKusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N. F., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.10.044 · Cited by 1,008 · see citing works
2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · EP Europace · doi:10.1093/europace/euab232 · Cited by 927 · see citing works
Self-citationKusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N. F., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000628 · Cited by 603 · see citing works
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.03.004 · Cited by 484 · see citing works
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya‐Mitjans, À., de Lange, F. J., Deharo, J., Elliot, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martiın, A., et al. (2018) · Kardiologia Polska · doi:10.5603/kp.2018.0161 · Cited by 474 · see citing works
Self-citationShen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000499 · Cited by 453 · see citing works
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000498 · Cited by 408 · see citing works
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.003 · Cited by 327 · see citing works
Practical Instructions for the 2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya‐Mitjans, À., de Lange, F. J., Deharo, J., Elliot, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martı́n, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy071 · Cited by 238 · see citing works
Self-citation2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy
Brignole, M., Auricchio, A., Barón‐Esquivias, G., Bordachar, P., Boriani, G., Breithardt, O. A., Cleland, J. G. F., Deharo, J.-C., Delgado, V., Elliott, P. M., et al. (2014) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2013.11.003 · Cited by 198 · see citing works
Self-citationShen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.002 · Cited by 155 · see citing works
ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Nielsen, J. C., Petersen, H. H., Karlsen, F. M., Chri, L. S., & Haarbo, J. (2014) · Cited by 146 · see citing works
Aksu, T., Gölcük, E., Yalın, K., Güler, T. E., & Erden, İ. (2015) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12756 · Cited by 145 · see citing works
Kusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2018) · Heart Rhythm · doi:10.1016/j.hrthm.2018.10.036 · Cited by 138 · see citing works
Kusumoto, F. M., Schoenfeld, M. H., Barrett, C., Edgerton, J. R., Ellenbogen, K. A., Gold, M. R., Goldschlager, N. F., Hamilton, R. M., Joglar, J. A., Kim, R. J., et al. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2018.10.037 · Cited by 131 · see citing works
JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias
Ono, K., Iwasaki, Y., Akao, M., Ikeda, T., Ishii, K., Inden, Y., Kusano, K., Kobayashi, Y., Koretsune, Y., Sasano, T., et al. (2022) · Circulation Journal · doi:10.1253/circj.cj-20-1212 · Cited by 132 · see citing works
Brignole, M., Donateo, P., Tomaino, M., Massa, R., Iori, M., Beiras, X., Moya, A., Kus, T., Deharo, J. C., Giuli, S., et al. (2014) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.113.001103 · Cited by 127 · see citing works
Self-citationVagally mediated atrioventricular block: pathophysiology and diagnosis
Alboni, P., Holz, A., & Brignole, M. (2013) · Heart · doi:10.1136/heartjnl-2012-303220 · Cited by 125 · see citing works
Self-citationThijs, R. D., Brignole, M., Falup‐Pecurariu, C., Fanciulli, A., Freeman, R. L., Guaraldi, P., Jordan, J., Habek, M., Hilz, M. J., Traon, A. P., et al. (2021) · Clinical Autonomic Research · doi:10.1007/s10286-020-00738-6 · Cited by 110 · see citing works
Self-citationFlammang, D., Church, T. R., De Roy, L., Blanc, J.-J., Leroy, J., Mairesse, G. H., Otmani, A., Graux, P. J., Frank, R., Purnode, P., et al. (2012) · Circulation · doi:10.1161/circulationaha.111.022855 · Cited by 93 · see citing works
Saklani, P., Krahn, A. D., & Klein, G. J. (2013) · Circulation · doi:10.1161/circulationaha.112.138396 · Cited by 89 · see citing works
New Concepts in the Assessment of Syncope
Brignole, M., & Hamdan, M. H. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.11.056 · Cited by 75 · see citing works
Self-citationSyncope and paroxysmal atrioventricular block
Aste, M., & Brignole, M. (2017) · Journal of Arrhythmia · doi:10.1016/j.joa.2017.03.008 · Cited by 69 · see citing works
Self-citationJCS/JHRS 2022 Guideline on Diagnosis and Risk Assessment of Arrhythmia
Takase, B., Ikeda, T., Shimizu, W., Abe, H., Aiba, T., Chinushi, M., Koba, S., KUSANO, K. F., Niwano, S., Takahashi, N., et al. (2023) · Circulation Journal · doi:10.1253/circj.cj-22-0827 · Cited by 67 · see citing works
Mechanism of syncope without prodromes with normal heart and normal electrocardiogram
Brignole, M., Guieu, R., Tomaino, M., Iori, M., Ungar, A., Bertolone, C., Unterhuber, M., Bottoni, N., Tesi, F., & Claude Deharo, J. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2016.08.046 · Cited by 59 · see citing works
Self-citationUngar, A., Sgobino, P., Russo, V., Vitale, E., Sutton, R., Melissano, D., Beiras, X., Bottoni, N., Ebert, H. H., Gulizia, M., et al. (2013) · Heart · doi:10.1136/heartjnl-2013-304399 · Cited by 58 · see citing works
Self-citationThijs, R. D., Brignole, M., Falup‐Pecurariu, C., Fanciulli, A., Freeman, R. L., Guaraldi, P., Jordan, J., Habek, M., Hilz, M. J., Traon, A. P., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102792 · Cited by 56 · see citing works
Self-citationDeharo, J., Mechulan, A., Giorgi, R., Franceschi, F., Prévôt, S., Peyrouse, E., Condo, J., By, Y., Ruf, J., Brignole, M., et al. (2012) · Heart · doi:10.1136/heartjnl-2011-301411 · Cited by 54 · see citing works
Self-citationSyncope Without Prodromes in Patients With Normal Heart and Normal Electrocardiogram
Deharo, J.-C., Guieu, R., Mechulan, A., Peyrouse, E., Kipson, N., Ruf, J., Gerolami, V., Devoto, G., Marrè, V., & Brignole, M. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.05.060 · Cited by 53 · see citing works
Self-citationTwenty-five years of research on syncope
Fedorowski, A., Kułakowski, P., Brignole, M., de Lange, F. J., Kenny, R. A., Moya‐Mitjans, À., Rivasi, G., Sheldon, R. S., van Dijk, J. G., Sutton, R., et al. (2023) · EP Europace · doi:10.1093/europace/euad163 · Cited by 49 · see citing works
Self-citationNew insights in diagnostics and therapies in syncope: a novel approach to non-cardiac syncope
Brignole, M., & Rivasi, G. (2021) · Heart · doi:10.1136/heartjnl-2020-318261 · Cited by 48 · see citing works
Self-citationAdenosine and clinical forms of neurally-mediated syncope
Guieu, R., Deharo, J.-C., Ruf, J., Mottola, G., Kipson, N., Bruzzese, L., Gerolami, V., Franceschi, F., Ungar, A., Tomaino, M., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.04.066 · Cited by 46 · see citing works
Self-citationJCS / JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias
Ono, K., Iwasaki, Y., Akao, M., Ikeda, T., Ishii, K., Inden, Y., Kusano, K., Kobayashi, Y., Koretsune, Y., Sasano, T., et al. (2022) · Journal of Arrhythmia · doi:10.1002/joa3.12714 · Cited by 41 · see citing works
Rudbeck-Resdal, J., Christiansen, M. K., Johansen, J. B., Nielsen, J. C., Bundgaard, H., & Jensen, H. K. (2019) · EP Europace · doi:10.1093/europace/euz206 · Cited by 42 · see citing works
Catheter Ablation of Bradyarrhythmia: From the Beginning to the Future
Aksu, T., Güler, T. E., Yalın, K., Mutluer, F. O., Özcan, K. S., & Calò, L. (2017) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2017.11.016 · Cited by 37 · see citing works
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.03.005 · Cited by 34 · see citing works
Key challenges in the current management of syncope
Sutton, R., Brignole, M., & Benditt, D. G. (2012) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2012.102 · Cited by 33 · see citing works
Self-citationGopinathannair, R., Salgado, B. C., & Olshansky, B. (2018) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2018.22.2 · Cited by 32 · see citing works
Blanc, J.-J. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2012.11.002 · Cited by 29 · see citing works
Efficacy of theophylline in patients affected by low adenosine syncope
Brignole, M., Solari, D., Iori, M., Bottoni, N., Guieu, R., & Deharo, J. C. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2015.12.016 · Cited by 29 · see citing works
Self-citationJoulia, F., Coulange, M., Lemaître, F., Costalat, G., Franceschi, F., Gariboldi, V., Née, L., Fromonot, J., Bruzzese, L., Gravier, G., et al. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.08.053 · Cited by 29 · see citing works
Self-citationBertini, M., Canovi, L., Vitali, F., Marcantoni, L., Pastore, G., Volpicelli, M., Munciguerra, O., Biffi, M., Ziacchi, M., Rossi, L. C., et al. (2025) · EP Europace · doi:10.1093/europace/euaf181 · Cited by 28 · see citing works
Plasma adenosine and neurally mediated syncope: ready for clinical use
Brignole, M., Groppelli, A., Brambilla, R., Caldara, G., Torresani, E., Parati, G., Solari, D., Ungar, A., Rafanelli, M., Deharo, J., et al. (2020) · EP Europace · doi:10.1093/europace/euaa070 · Cited by 25 · see citing works
Self-citationEfficacy of theophylline in patients with syncope without prodromes with normal heart and normal ECG
Brignole, M., Iori, M., Solari, D., Bottoni, N., Rivasi, G., Ungar, A., Deharo, J., & Guieu, R. (2019) · International Journal of Cardiology · doi:10.1016/j.ijcard.2019.03.043 · Cited by 25 · see citing works
Self-citationGuía ESC 2021 sobre estimulación cardiaca y terapia de resincronización
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2022) · Revista Española de Cardiología · doi:10.1016/j.recesp.2021.10.025 · Cited by 26 · see citing works
Self-citationDiretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023
Teixeira, R. A., Fagundes, A. A., Baggio, J. M., de Oliveira, J. C., Medeiros, P. D. T. J., Valdigem, B. P., Teno, L. A. C., Silva, R. T., de Melo, C. S., Elías, J., et al. (2023) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20220892 · Cited by 50 · see citing works
Tests for the identification of reflex syncope mechanism
Brignole, M., Rivasi, G., Fedorowski, A., Ståhlberg, M., Groppelli, A., & Ungar, A. (2023) · Expert Review of Medical Devices · doi:10.1080/17434440.2023.2174428 · Cited by 24 · see citing works
Self-citationManual zur Diagnostik und Therapie von Synkopen
von Scheidt, W., Bosch, R., Klingenheben, T., Schuchert, A., Stellbrink, C., & Stockburger, M. (2019) · Der Kardiologe · doi:10.1007/s12181-019-0319-0 · Cited by 21 · see citing works
Ricci, F., Sutton, R., Palermi, S., Tana, C., Renda, G., Gallina, S., Melander, O., Caterina, R. D., & Fedorowski, A. (2018) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.13715 · Cited by 21 · see citing works
2020 Clinical practice guidelines for Bradyarrhythmias and conduction disorders
Revishvili, A. S., Artyukhina, Е. А., Глезер, М. Г., Базаев, В. А., Batalov, R. E., Bokeria, L. A., Bokeria, O. L., Davtyan, K. V., Ivanitsky, E. A., Ковалев, А. С., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4448 · Cited by 28 · see citing works
Syncope and Idiopathic (Paroxysmal) AV Block
Brignole, M., Deharo, J., & Guieu, R. (2015) · Cardiology Clinics · doi:10.1016/j.ccl.2015.04.012 · Cited by 21 · see citing works
Self-citationAdenosine hypersensitivity and atrioventricular block
Deharo, J., Brignole, M., & Guieu, R. (2018) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-018-0570-2 · Cited by 19 · see citing works
Self-citationMoya‐Mitjans, À., Rivas‐Gándara, N., Sarrias, A., Pérez‐Rodon, J., & Roca‐Luque, I. (2012) · Revista Española de Cardiología · doi:10.1016/j.recesp.2012.03.005 · Cited by 18 · see citing works
Jensen, L. O., Vikman, S., Antonsen, L., Kosonen, P., Niemelä, M. J., Christiansen, E. H., Kervinen, K., Ērglis, A., Harnek, J., Kumsārs, I., et al. (2017) · Cardiovascular revascularization medicine · doi:10.1016/j.carrev.2017.05.010 · Cited by 18 · see citing works
JCS / JHRS 2022 Guideline on Diagnosis and Risk Assessment of Arrhythmia
Takase, B., Ikeda, T., Shimizu, W., Abe, H., Aiba, T., Chinushi, M., Koba, S., KUSANO, K. F., Niwano, S., Takahashi, N., et al. (2024) · Journal of Arrhythmia · doi:10.1002/joa3.13052 · Cited by 20 · see citing works
Serial Gray Scale Intravascular Ultrasound Findings in Late Drug-Eluting Stent Restenosis
Hakim, D. A., Mintz, G. S., Sanidas, E. A., Rusinova, R., Weisz, G., Leon, M. B., Moses, J. W., Stone, G. W., & Maehara, A. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.11.027 · Cited by 17 · see citing works
Fragakis, N., Antoniadis, A. P., Saviano, M., Vassilikos, V. P., & Pappone, C. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.01.089 · Cited by 16 · see citing works
Brignole, M., Iori, M., Strano, S., Tomaino, M., Rivasi, G., Ungar, A., Carretta, D. M., Solari, D., Napoli, P., Deharo, J., et al. (2021) · EP Europace · doi:10.1093/europace/euab300 · Cited by 15 · see citing works
Self-citationLakkireddy, D. (2019) · Journal of Atrial Fibrillation · doi:10.4022/jafib.2396 · Cited by 14 · see citing works
Mechanism-based therapy of non-cardiac syncope: a practical guide
Brignole, M., Rivasi, G., & Fedorowski, A. (2024) · EP Europace · doi:10.1093/europace/euae073 · Cited by 12 · see citing works
Self-citationSutton, R. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00048 · Cited by 13 · see citing works
Does A Therapy for Reflex Vasovagal Syncope Really Exist?
Romano, S. L., Branz, L., Fondrieschi, L., & Minuz, P. (2019) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-019-00327-3 · Cited by 13 · see citing works
Novedades en electrofisiología cardiaca y arritmias
Hernández‐Madrid, A., Francés, R. M., & Moro, C. (2011) · Revista Española de Cardiología · doi:10.1016/s0300-8932(11)70011-2 · Cited by 11 · see citing works
Idiopathic Paroxysmal Atrio-Ventricular Block. What is The Mechanism?
Guerrero-Márquez, F. J., Arana‐Rueda, E., & Pedrote, A. A. (2016) · Journal of Atrial Fibrillation · doi:10.4022/jafib.1449 · Cited by 11 · see citing works
Tilt Table Testing and Implantable Loop Recorders for Syncope
Sheldon, R. S. (2012) · Cardiology Clinics · doi:10.1016/j.ccl.2012.10.009 · Cited by 11 · see citing works
Komatsu, S., Sumiyoshi, M., Miura, S., Kimura, Y., Shiozawa, T., Hirano, K., Odagiri, F., Tabuchi, H., Hayashi, H., Sekita, G., et al. (2016) · Journal of Arrhythmia · doi:10.1016/j.joa.2016.10.004 · Cited by 11 · see citing works
Ragupathi, L., Johnson, D. M., Greenspon, A. J., Frisch, D. R., Ho, R. T., & Pavri, B. B. (2018) · Heart Rhythm · doi:10.1016/j.hrthm.2018.04.013 · Cited by 11 · see citing works
Atrioventricular Conduction System Disease
Vijayaraman, P., & Ellenbogen, K. A. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-37804-8.00014-6 · Cited by 11 · see citing works
What is the mechanism of paroxysmal atrioventricular block in a patient with recurrent syncope?
Bansal, R., Mahajan, A., Rathi, C. D., Mehta, A., & Lokhandwala, Y. Y. (2019) · Journal of Arrhythmia · doi:10.1002/joa3.12245 · Cited by 11 · see citing works
Pacing Therapies for Vasovagal Syncope
Lakkireddy, D. (2020) · Journal of Atrial Fibrillation · doi:10.4022/jafib.2406 · Cited by 11 · see citing works
García‐Pedraza, J. Á., García, M., Martín, M. L., Eleno, N., & Morán, A. (2016) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000000433 · Cited by 9 · see citing works
Blanc, J. J., & Dauphin, C. (2013) · EP Europace · doi:10.1093/europace/eut322 · Cited by 9 · see citing works
Brignole, M., Deharo, J., & Guieu, R. (2014) · Springer eBooks · doi:10.1007/978-3-319-09102-0_7 · Cited by 9 · see citing works
Self-citationAn Investigation of Metabolic Risk Factors and Gut Microbiota in Unexplained Syncope
Longo, S., CHIERICO, F. D., Scanu, M., Toto, F., Legramante, J. M., Rizza, S., Putignani, L., & Federici, M. (2024) · Biomedicines · doi:10.3390/biomedicines12020264 · Cited by 8 · see citing works
Moya‐Mitjans, À., Roca‐Luque, I., Pascual, J. F., Pérez‐Rodon, J., & Rivas‐Gándara, N. (2012) · Cardiology Clinics · doi:10.1016/j.ccl.2012.10.001 · Cited by 7 · see citing works
López, C., Gómez‐Roso, M., García‐Pedraza, J. Á., Martín, M. L., Morán, A., & García, M. (2018) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/cjpp-2018-0390 · Cited by 8 · see citing works
Chung, W., Do, D. H., Erbay, M. İ., & Ajijola, O. A. (2025) · Heart Rhythm · doi:10.1016/j.hrthm.2025.09.022 · Cited by 6 · see citing works
2025 Clinical practice guidelines for Bradyarrhythmias and conduction disorders
Revishvili, A. S. H., Glezer, M. G., Artyukhina, Е. А., Базаев, В. А., Batalov, R. E., Bockeria, L. A., Davtyan, K. V., Lebedev, D. S., Лебедева, В. К., Lyubimtseva, T. A., et al. (2026) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2025-6669 · Cited by 8 · see citing works
Emerging concepts in diagnosis and treatment of syncope by pacing
Sutton, R., Deharo, J., Brignole, M., & Hamdan, M. H. (2018) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2018.01.009 · Cited by 6 · see citing works
Self-citationNeurologic complications of brady-arrhythmias
Osteraas, N. D. (2021) · Handbook of clinical neurology · doi:10.1016/b978-0-12-819814-8.00006-8 · Cited by 6 · see citing works
Adenosine and neurohumoral syncope
Deharo, J., Brignole, M., & Guieu, R. (2022) · Minerva Medica · doi:10.23736/s0026-4806.21.07537-6 · Cited by 6 · see citing works
Self-citationPrevalence and Clinical Characteristics of Patients with Pause-Dependent Atrioventricular Block
Bun, S., Asarisi, F., Heme, N., Squara, F., Scarlatti, D., Taghji, P., Deharo, J., Moceri, P., & Ferrari, É. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11020449 · Cited by 6 · see citing works
Self-citationAlmanac 2013: cardiac arrhythmias and pacing
Liew, R. (2013) · Heart · doi:10.1136/heartjnl-2013-304592 · Cited by 5 · see citing works
Saito, K., Takeda, S., Saito, Y., Kawamura, M., Yoshikawa, Y., Yano, H., & Sata, M. (2014) · The Journal of Medical Investigation · doi:10.2152/jmi.61.380 · Cited by 5 · see citing works
Explaining the Unexplained Causes of Syncope
Mehta, N., Távora, M. Z. P., & Morillo, C. A. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.01.039 · Cited by 5 · see citing works
Syncope and Idiopathic (Paroxysmal) AV Block
Brignole, M., Deharo, J., & Guieu, R. (2013) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2013.08.008 · Cited by 4 · see citing works
Self-citationTransient sick sinus syndrome with complete atrioventricular block associated with ergonovine intake
Wang, H., Liu, W., & Chen, Y. (2017) · Medicine · doi:10.1097/md.0000000000008559 · Cited by 4 · see citing works
Pathophysiology of Vasovagal Syncope: Conclusive Remarks
Furlan, R., Alboni, P., & Mosqueda‐Garcia, R. (2014) · Springer eBooks · doi:10.1007/978-3-319-09102-0_9 · Cited by 4 · see citing works
The adenosine triphosphate test in the diagnosis of unexplained syncope: a test looking for a home
Matthews, I., Sutton, R., Blanc, J. J., & Parry, S. W. (2014) · EP Europace · doi:10.1093/europace/euu082 · Cited by 4 · see citing works
Liew, R. (2014) · Acta cardiologica. Supplementum · doi:10.1080/ac.69.2.3017312 · Cited by 3 · see citing works
Intraventricular Conduction Abnormalities
Issa, Z. F., Miller, J. M., & Zipes, D. P. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-52356-1.00010-4 · Cited by 3 · see citing works
Novel Therapeutic Options in the Management of Reflex Syncope
Podoleanu, C., & Deharo, J. (2019) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000000923 · Cited by 2 · see citing works
Self-citationLi, Y., Hong, Y., Ma, J., Cao, G., Zhou, X., Zhang, J., Xing, Q., & Tang, B.-P. (2021) · Angiology · doi:10.1177/00033197211028022 · Cited by 2 · see citing works
Novedades en electrofisiología cardiaca y arritmias
Palmero, M. J. G., Alonso‐Martín, C., Font, E. R., & Viñolas, X. (2012) · Revista Española de Cardiología · doi:10.1016/j.recesp.2011.10.034 · Cited by 3 · see citing works
Táborský, M., Kautzner, J., Fedorco, M., Čurila, K., Wünschová, H., Pyszko, J., Novák, M., Kozák, M., Válek, M., Polášek, R., et al. (2022) · Cor et Vasa · doi:10.33678/cor.2022.024 · Cited by 2 · see citing works
- Authors
- Brignole, M., Deharo, J.-C., De Roy, L., Menozzi, C., Blommaert, D., Dabiri, L., Ruf, J., & Guieu, R.
- Affiliations
- Presidio Ospedaliero (IT)
- Hôpital de la Timone (FR)
- Santa Maria Nuova Hospital (IT)
- CHU Dinant Godinne UCL Namur (BE)
- Corresponding author
- Brignole, Michele
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 58
- Issue
- 2
- Pages
- 167-173
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1692004657
- Semantic Scholar
- 60387dcc854b0991a5c293c6161e7d377c05710b
- Cited by
- 147
- References
- 25
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 11 · 2020: 6 · 2019: 13 · 2018: 13 · 2017: 17 · 2016: 6 · 2015: 9 · 2014: 15 · 2013: 15 · 2012: 11
- FWCI
- 14.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- syncope, paroxysmal atrioventricular block, complete heart block, cardiac pacing, vagal tone, cardiac conduction disorders, recurrent syncope
- MeSH terms
- Adenosine, Adenosine Triphosphate, Adult, Aged, Electrocardiography, Electrophysiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Syncope, Time Factors, Atrioventricular Block
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
