Adams-Stokes syndrome due to sinoatrial block

A case of a 29 year old female patient with sinoatrial block, first degree A-V heart block and Adams-Stokes seizures since the age of 11 is reported. The mechanism of the syncopal attacks was established by continuous radioelectrocardiographic monitoring as episodes of sinoatrial heart block or arrest, or both. There was no evidence of inflammatory, degenerative or congenital heart disease, and the patient had never received drugs assocated with the production of Adams-Stokes seizures. From the etiologic standpoint exaggerated vagal effects undoubtedly played a role; the existence of a congenital abnormality of the conduction system must, however, be taken into consideration. Treatment with artificial pacemaker stimulation proved effective and prevented further Adams-Stokes attacks.