Gastric Dysrhythmia Corrected by Dual Chamber Pacemaker Implantation

Marcio Galindo Kiuchi



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.


autonomic nervous system; central nervous system; gastric dysrhythmias; pacemaker; vomiting.

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Hasler WL, Chey WD. Nausea and vomiting. Gastroenterology. 2003 Dec; 125 (6):1860-7. DOI: 10.1053/j.gastro.2003.09.040

Stern RM, Koch LK, Andrews PLR. Nausea: mechanisms and management. 2011. New York: Oxford University Press; (viii, 462 p.) : ill. DOI: 10.1016/B0-12-386860-2/00498-6

Horn CC. Why is the neurobiology of nausea and vomiting so important? Appetite. 2008 Mar-May; 50 (2-3):430-4. DOI: 10.1016/j.appet.2007.09.015

Horn CC. The medical implications of gastrointestinal vagal afferent pathways in nausea and vomiting. Curr Pharm Des. 2014; 20 (16):2703-12. DOI: 10.2174/13816128113199990568

LaCount LT, Barbieri R, Park K, Kim J, Brown EN, Kuo B, Napadow V. Static and dynamic autonomic response with increasing nausea perception. Aviat Space Environ Med. 2011 Apr; 82 (4):424-33.

Sclocco R, Kim J, Garcia RG, Sheehan JD, Beissner F, Bianchi AM, Cerutti S, Kuo B, Barbieri R, Napadow V. Brain circuitry supporting multi-organ autonomic outflow in response to nausea. Cereb Cortex. 2016 Feb; 26 (2):485-97. DOI: 10.1093/cercor/bhu172

Departamento de Estimulação Cardíaca Artificial da Sociedade Brasileira de Cirurgia Cardiovascular (DECA/SBCCV). Diretrizes Brasileiras de Dispositivos Cardíacos Eletrônicos Implantáveis do Departamento de Estimulação Cardíaca Artificial (DECA) da Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) 2015. 5 de Agosto de 2015: 1-62.

Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. International Cardiovascular Forum Journal 2015;2:2 DOI: 10.17987/icfj.v2i1.4


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