Syncope due to Recurrent Asystole in the Recovery Phase of Exercise Testing

Authors

  • Caio Vittor Roque de Almeida Reis Pontifícia Universidade Católica de Goiás – Medical School – Goiânia (GO), Brazil. https://orcid.org/0009-0006-3971-9671
  • Israel Guilharde Maynarde Hospital do Coração de Goiás – Department of Ergometry – Goiânia (GO), Brazil. https://orcid.org/0009-0003-6846-8670
  • Luciana Fernandes Balestra Hospital do Coração Anis Rassi – Department of Clinical Arrhythmology – Goiânia (GO), Brazil | Hospital de Urgências de Goiás – Department of Clinical Cardiology – Goiânia (GO), Brazil. https://orcid.org/0009-0006-0123-357X
  • Giulliano Gardenghi Hospital do Coração Anis Rassi – Department of Clinical Arrhythmology – Goiânia (GO), Brazil | Hospital Encore – Department of Scientific Coordination – Aparecida de Goiânia (GO), Brazil. https://orcid.org/0000-0002-8763-561X

DOI:

https://doi.org/10.24207/jca.v38i1.3570

Keywords:

Syncope, vasovagal, Heart Arrest, Ergometry, Unconsciousness

Abstract

We describe a clinical case of a 20-year-old male who was referred for an exercise stress test, undergoing cardiologic follow-up for 11 years due to episodes of syncope. Shortly after the end of the exercise phase, he presented recurrent episodes of asystole, associated with loss of consciousness, followed by spontaneous recovery.

Downloads

Download data is not yet available.

References

1. Sutton R. Reflex syncope: Diagnosis and treatment. J Arrhythm. 2017;33(6):545-52. https://doi.org/10.1016/j.joa.2017.03.007

2. Gardenghi G, Balestra LF. Tratamento não-farmacológico da síncope neuromediada. J Card Arrhythm [Internet]. 2011 [cited Sep 19, 2025];24(3):145-50. Retrieved from https://jca.org.br/jca/article/view/2579

3. Secher NH, Clausen JP, Klausen K, Noer I, Trap-Jensen J. Central and regional circulatory effects of adding arm exercise to leg exercise. Acta Physiol Scand. 1977;100(3):288-97. https://doi.org/10.1111/j.1748-1716.1977.tb05952.x

4. Ghorayeb N, Costa RVC, Castro I, Daher DJ, Oliveira Filho JA, Oliveira MAB, et al. Diretriz em cardiologia do esporte e do exercício da Sociedade Brasileira de Cardiologia e da Sociedade Brasileira de Medicina do Esporte. Arq Bras Cardiol. 2013;100(1 Supl. 2):1-41. https://doi.org/10.5935/abc.2013S002

5. Ghorayeb N, Dioguardi GS. Tratado de cardiologia do exercício e do esporte. São Paulo: Atheneu; 2007.

6. Mallet ALR. Síncope: abordagem diagnóstica. Rev SOCERJ [Internet]. 1999 [cited Sep 19, 2025];12(1):422-9. Retrieved from https://sociedades.cardiol.br/socerj/revista/1999_01/a1999_v12_n01_art11.pdf

7. Ulucan Ş, Kaya Z, Keser A, Katlandur H, Karanfil M, Ateş İ. Deterioration of heart rate recovery index in patients with erectile dysfunction. Anatol J Cardiol. 2016;16(4):264-9. https://doi.org/10.5152/AnatolJCardiol.2015.6132

8. Tse HF, Lau CP. Exercise-associated cardiac asystole in persons without structural heart disease. Chest. 1995;107(2):572-6. https://doi.org/10.1378/chest.107.2.572

9. Fleg JL, Asante AVK. Asystole following treadmill exercise in a man without organic heart disease. Arch Intern Med. 1983;143(9):1821-2.

10. Winker R, Frühwirth M, Saul P, Rüdiger HW, Pezawas T, Schmidinger H, et al. Prolonged asystole provoked by head-up tilt testing. Clin Res Cardiol. 2006;95(1):42-7. https://doi.org/10.1007/s00392-006-0310-1

11. Hirata T, Yano K, Okui T, Mitsuoka T, Hashiba K. Asystole with syncope following strenuous exercise in a man without organic heart disease. J Electrocardiol. 1987;20(3):280-3. https://doi.org/10.1016/s0022-0736(87)80027-4

12. Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021;42(35):3427-520. https://doi.org/10.1093/eurheartj/ehab364. Erratum in: Eur Heart J. 2022;43(17):1651. https://doi.org/10.1093/eurheartj/ehac075

13. Ali M, Pachon Maetos JC, Kichloo A, Masudi S, Grubb BP, Kanjwal K. Management strategies for vasovagal syncope. Pacing Clin Electrophysiol. 2021;44(12):2100-8. https://doi.org/10.1111/pace.14402

Downloads

Published

2025-10-03

How to Cite

Reis, C. V. R. de A., Maynarde, I. G., Balestra, L. . F., & Gardenghi, G. (2025). Syncope due to Recurrent Asystole in the Recovery Phase of Exercise Testing. JOURNAL OF CARDIAC ARRHYTHMIAS, 38. https://doi.org/10.24207/jca.v38i1.3570

Issue

Vol. 38 (2025)

Section

Clinical Arrythmia

Categories