epilepsja ,bradykardia ,zahamowania zatokowe i utraty przytomnosci.

W NEJM znalzalem ciekawy artykul ktory byl dla mnie nowoscia,ze napady epi moga wywolywac gozne bradykardie i asystolie i nie zawsze wszczepienie stymulatora pomaga.Zazwyczaj sie uwaza ze pacjenci niekiedy  sa niepotrzebnie leczeni na epi,sa zle zdiagnozowani  i  maja bradyarytmie prowadzace do zespolow MAS i po wszczepieniu stymulatora utraty przytomnosci  powinny ustapic.Przytaczam artykul z NEJM na ten temat i czy miesliscie takie przypadki..

Persistent Fainting after Implantation of a "Curative" Pacemaker

To the Editor: Syncope is a common and disabling problem, andits cause may be difficult to elucidate. A 64-year-old right-handedmale taxi driver was referred to us for the investigation ofsyncope in April 2007. Four weeks previously, at dinner, hehad suddenly felt strange and dizzy before losing consciousnessfor 2 minutes. On recovery, he was fully oriented. Several daysbefore admission, he described feelings of "impending doom"that lasted for 2 minutes during breakfast.

He was previously well. He was a nondrinker and nonsmoker, andhe was taking aspirin for secondary prevention of a transientischemic attack. Results of physical examination, blood tests,electrocardiography (ECG), echocardiography, 48-hour Holtermonitoring, and magnetic resonance imaging of the brain andelectroencephalography (EEG) after he had undergone sleep deprivationwere normal; an implantable loop recorder was