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Chest, Vol 91, 919-920, Copyright © 1987 by American College of Chest Physicians

ARTICLES

Vasodilator therapy-induced pacemaker syndrome

LK Toivonen and S Pohjola-Sintonen

Disabling presyncopal attacks were provoked in a patient with a sinus nodal disorder and cardiac pacemaker by treatment with antianginal vasodilators. At cardiac catheterization a severe fall in aortic pressure was documented during ventricular pacing, when desynchronized atrial contractions coincided with ventricular systoles. After withdrawal of the medication, no obvious changes in arterial pressure were associated with ventricular pacing, and the patient became free of dizziness. Vasodilating drugs may provoke episodic hypotension with characteristic features of the pacemaker syndrome.




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Copyright © 1987 by the American College of Chest Physicians.