Possibili effetti proaritmici delle manovre di stimolazione vagale.

Vagal stimulation manoeuvres are currently used in clinical practice both for diagnostic and therapeutic purposes. Such manoeuvres are not, however, without risk. The Authors describe the case of a patient in whom, in the past, a Lown-Ganong-Levine syndrome had been diagnosed. During a vagal stimulation, performed because of a suspected paroxysmal supraventricular tachycardia crisis, a sudden increase of ventricular rate, up to 280 b/min, occurred. At the end of this paroxysm, the presence of an atrial flutter was ascertained. The high ventricular rate was thus attributed to an 1:1 A-V conduction which occurred because of the performed manoeuvres. The possibility of causing not only hypokinetic but also potentially dangerous hyperkinetic arrhythmias must be held in consideration; the vagal stimulation manoeuvres therefore should not be performed without the possibility of electrocardiographic monitoring.