The mechanism of syncope associated with chronic auricular fibrillation without evidence of organic heart disease: cure, after ten years, by restoration of sinus rhythm with quinidine.

Abstract

THE unusual opportunity of observing a patient with long-standing auricular fibrillation during an episode of syncope and of studying the possible mechanism responsible for the syncopal attack impels us to report the following case. Syncope or faintness is not unusual in patients with paroxysmal auricular fibrillation at the onset of the arrhythmia due to tachycardia or the sudden change in rhythm.1 2 3 4 However, it is not a part of the clinical picture of established auricular fibrillation with relatively slow and unchanged ventricular rate in the patient with organic heart disease. Although syncope is often listed as one of the possible symptoms . . .