The association of syncope and convulsions with a slow pulse, termed the MorgagniAdams-Stokes or Adams-Stokes (A-S) syndrome, is usually due to venticular standstill secondary to failure of the idioventricular pacemaker in advanced or complete heart block.1 Occasionally the A-S syndrome is due to extreme sinus bradycardia without heart block, e.g., rates below 20 per minute, with consequent intolerably prolonged cerebral ischemia between ventricular beats. In some cases of heart block and A-S syndrome due to ventricular standstill, other attacks of A-S syndrome may be due to paroxysms of ventricular tachycardia or ventricular fibrillation. However, it is uncommon for the cardiac arrest in a given case of A-S syndrome to be due exclusively to ventricular fibrillation as contrasted with ventricular standstill. Although cases of A-S syndrome due exclusively to ventricular fibrillation in the presence of complete heart block have been reported, we have never previously documented this in any patient
SACOLICK SL, STEIN WG, FRIEDBERG CK. Complete Heart Block with Adams-Stokes Seizures from Ventricular Fibrillation: Recovery After Treatment with Repeated External Electrical Defibrillation. Arch Intern Med. 1962;110(3):299–304. doi:10.1001/archinte.1962.03620210023006
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