DOI: 10.36347/sjams.2019.v07i02.078

Pages: 792-797

Introduction: The autonomic nervous system (ANS) controls all body functions. Dysregulation of this system may be responsible of bradycardia. The main objective of our study is to describe the autonomic profile of patients with bradycardia and to determine, through testing cardiovascular autonomic reflexes its involvement in the pathogenesis of idiopathic symptomatic bradycardia. Materials and methods: This is a retrospective study including 72 patients with bradycardia. The study was conducted in the ANS unit of the cardiology department in Mohamed VI hospital of Marrakech. All patients had clinical examination, electrocardiogram, and biological exam and autonomic nervous system tests. Results: The average age of the patients was 44 years old with a female predominance. The mean heart rate was 50 bpm. Patients had polymorphic functional symptoms. The autonomic profile of patients with bradycardia revealed a significant predominance of vagal hyperactivity, which is present in 83.3% of patients. Increased vagal tone was associated with a peripheral sympathetic alpha deficiency in 30, 5% of the cases, a peripheral sympathetic beta deficiency in 25% and even a peripheral sympathetic beta hyperactivity in 54,1% of patients. The main autonomic syndromes found were: postural orthostatic tachycardia syndrome (POTS) in 34,7% of patients, orthostatic hypotension in 25% of the cases , vasovagal syncope in 8,3%, and the baro-receptor abnormality in 12,5% of the patients. The treatment, depending on the autonomic abnormality showed an improvement in the functional state of the patients. Conclusion: Autonomic profile study helps to explain the causes of symptoms described by the patients with bradycardia who’s clinical and conventional paraclinical examinations are normal.