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The Mysterious Case of an Athletic Woman with Recurrent Syncope and a “Normal” Heart
Journal article   Open access   Peer reviewed

The Mysterious Case of an Athletic Woman with Recurrent Syncope and a “Normal” Heart

Samuel L. Johnston, Mahi Ashwath, Barry London, Jennifer Torgerson, Aleksandra Tosic and Brian Olshansky
The Journal of innovations in cardiac rhythm management (Print), Vol.10(7), pp.3744-3749
07/15/2019
DOI: 10.19102/icrm.2019.100701
PMCID: PMC7252779
PMID: 32477741
url
https://doi.org/10.19102/icrm.2019.100701View
Published (Version of record) Open Access

Abstract

A 53-year-old female with a history of sports participation presented to a community hospital emergency department for collapse. She was given a LifeVest ® wearable cardioverter-defibrillator (WCD) (Zoll Medical Corp., Chelmsford, MA, USA) and scheduled to undergo cardiac magnetic resonance imaging (MRI) with gadolinium enhancement at a tertiary center. However, before the scheduled MRI scan could be performed, she developed tachycardia, for which the WCD alarmed. A dual-chamber implantable cardioverter-defibrillator was subsequently implanted. Assessment of a patient with syncope requires consideration of the idea that a life-threatening and recurrent arrhythmia may be a cause for the problem. However, current guidelines do not cover the routine use of WCDs in syncope. Additionally, the patient described here did not clearly meet United States Food and Drug Administration indications for the provision of an external defibrillator. We present this case to provoke discussion among colleagues regarding this patient’s treatment plan.
 Complex Case Study Implantable cardioverter-defibrillator syncope wearable cardioverter-defibrillator

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