Abstract
Syncope is a common cause of emergency department evaluation in older adults, when sudden loss of consciousness without prodromal symptoms raises concern for cardiac etiology. We present this case of an 80 year old woman with a prior history of vasovagal syncope who presented after a collapse. Initial evaluation, including electrocardiogram, telemetry, echocardiogram, and ambulatory monitoring, was unrevealing. Given the high risk clinical features such as lack of prodromal symptoms and sudden collapse, an inpatient electrophysiology (EP) study was pursued and demonstrated severe intra Hisian conduction disease with split His bundle electrograms and a markedly prolonged His–ventricular interval. A permanent pacemaker was implanted due to the high risk of progression to advanced atrioventricular (AV) block, with no recurrence of syncope. This case highlights intra Hisian block as an underrecognized cause of syncope and underscores the importance of further electrophysiologic evaluation when noninvasive testing is nondiagnostic.
Recommended Citation
Qamar, MD, Sheraz and Luo, MD, Meiqi
(2026)
"Sudden Syncope Due to Intra Hisian Block with Severely Prolonged His–Ventricular Interval Diagnosed on Electrophysiology Study,"
The Medicine Forum: Vol. 27, Article 12.
Available at:
https://jdc.jefferson.edu/tmf/vol27/iss1/12
