Gastric Dysrhythmia Corrected by Dual Chamber Pacemaker Implantation
Keywords:autonomic nervous system, central nervous system, gastric dysrhythmias, pacemaker, vomiting.
Nausea has been defined as an “unpleasant painless subjective feeling that one will imminently vomit”. While nausea and vomiting are often thought to exist on a temporal continuum, this is not always the case. There are situations when severe nausea may be present without emesis and less frequently, when emesis may be present without preceding nausea. The underlying mechanisms involved in nausea are complex and encompass psychological states, the central nervous system, autonomic nervous system, gastric dysrhythmias, and the endocrine system. We report a 92-year-old male patient with depression, hypothyroidism, and intermittent severe sinus dysfunction, causing nausea, vomiting, and fatigue, pre-syncope and low cerebral output. Dual chamber implantation was performed and 24 hours after the implantation of the device all the symptoms disappeared, the parameters of the pacemaker were stable, and the patient was discharged. At the 1st and the 3rd month after implantation the patient remained asymptomatic. Over-activity of autonomic outflow may be a determinant for overall nausea intensity, probably, may be a potential therapeutic target to be corrected, at least in part, by a dual chamber pacemaker implantation.
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