Herpes Simplex Encephalitis, an Unusual Cause of Sinus Node Dysfunction: Case Report and Literature Review

Nicol, Pierre-Philippe

doi:10.23937/2378-2951/1410042

Cited by 3 publications

(2 citation statements)

References 21 publications

(31 reference statements)

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“…Three cases of proven herpes encephalitis with syncope and sinus arrest have been described in the literature, one ended in death due to lack of antiviral treatment 1 and two ended in resolution of symptoms after antiviral treatment without the need for a permanent pacemaker. 2 , 3 …”

Section: Discussionmentioning

confidence: 99%

When the brain slows the heart—herpes encephalitis and sinus arrest: a case report

Braiman

Konstantino

Westreich

2021

European Heart Journal - Case Reports

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Background Herpes simplex virus (HSV) encephalitis is a known cause of cognitive deterioration, neurological disturbances, and seizures though are rarely associated with sinus node dysfunction. Case summary We present a 54-year-old man admitted to the hospital with a 10-day history of fever, confusion, and fatigue, 1 week following a transient loss of consciousness. An initial workup suggested HSV encephalitis and the patient was started on intravenous Acyclovir. Due to his episode of syncope, a 24 h Holter electrocardiogram monitoring was performed. The Holter documented multiple episodes of sinus arrest, with a second episode of syncope noticed by the hospital staff concurrent with the last documented sinus arrest. Following antiviral treatment and resolution of the encephalitis we noticed complete resolution of sinus node dysfunction. We subsequently avoided permanent pacemaker implantation. Discussion Our case of proven HSV encephalitis complicated by sinus node arrest and syncope with complete resolution following antiviral treatment suggests no indication for permanent pacemaker implantation. This approach is consistent with data from previously reported cases.

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Section: Discussionmentioning

confidence: 99%

When the brain slows the heart—herpes encephalitis and sinus arrest: a case report

Braiman

Konstantino

Westreich

2021

European Heart Journal - Case Reports

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“…Another reports a 48-year-old female with HSV encephalitis with several spontaneous pauses of 4 to 8 s during her sleep, with Holter monitoring after resolution of the encephalitis showing no further episodes [112]. Another case report also reports sinus node dysfunction in HSV encephalitis, manifesting as sinus pauses [113]. Lastly, another case report in 1986 documented HSV encephalitis with presented with sick sinus syndrome [114].…”

Section: Herpes Simplex Virusmentioning

confidence: 99%

Cardiac arrhythmias in viral infections

Lee

Garan

Wan

et al. 2023

J Interv Card Electrophysiol

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Background The currentCOVID-19 pandemic has led to many studies examining its arrhythmogenic effects. However, there are many other viruses that are capable of inducing arrhythmias that have not received as much attention. The objective of this study was to review common viruses and identify studies highlighting their arrhythmogenic effects. Methods and resultsIn this review, we examined 15 viruses and the literature regarding their arrhythmogenic effects. The common mechanisms of action appear to be direct invasion of myocytes leading to immune mediated damage, infection of vascular endothelium, and alteration of cardiac ion channels. Conclusions This review highlights the growing evidence that supports the involvement of other viral infections in the development of arrhythmia. Physicians should be aware of these potentially life-threatening effects when caring for patients with these viruses, some of which are very common. Additional studies are required to better understand the complex mechanism and risk factors of cardiac arrhythmias in patients suffered from viral infections to determine whether the processes can be reversed or even prevented.

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