Abstract
Single chamber VVI mode pacing proved to be ineffective in vasovagal syncope treatment [1], while several nonrandomized studies [2–4] showed a significant decrease in recurrence in patients who underwent dual chamber pacing. In the last few years, three randomized, noncontrolled studies have shown the efficacy of dual-chamber pacemaker implantation in reducing recurrence in patients with recurrent neuromediated syncope. The VPS study [5] demonstrated the effectiveness of rate-drop response pacemakers in patients affected by neurally mediated syncope who gave a positive response in the tilting test, presenting a varying cardoinhibitory component. The VASIS study [6], on the other hand, showed the effectiveness of a DDI-mode pacemaker with hysteresis in patients with neurally mediated syncope and positive tilting test with a marked cardoinhibitory component. Finally, the SYDIT trial [7] reported the superiority of pacemaker implantation over drug treatment with ß-blockers.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Benditt DG, Petersen M, Lurie KG et al (1995) Cardiac pacing for the prevention of recurrent vasovagal syncope. Ann Intern Med 122:204–209
Petersen MEV, Chamberlain-Webber R, Fitzpatrick AP et al (1994) Permanent pacing for cardioinhibitory malignant vasovagal syndrome. Br Heart J 71:274–281
Benditt DG, Sutton R, Gammage M, Fetter J, Markowitz T and the Rate-Drop Response Investigators (1997) Clinical experience with Thera DR rate drop response pacing algorithm in carotid sinus syndrome and vasovagal syncope. Pacing Clin Electrophysiol 20:832–839
Sheldon R, Koshman ML, Wilson W et al (1998) Effect of dual chamber pacing with automatic rate-drop sensing on recurrent neutrally mediated syncope. Am J Cardiol 81:158–162
Connolly SJ, Sheldon R, Roberts RS, Gent M (1999) The North American Vasovagal Pacemaker Study (VPS). A randomized trial of permanent cardiac pacing for the prevention of vasovagal syncope. J Am Coll Cardiol 33:16–20
Sutton R, Brignole M, Menozzi C et al on behalf of the Vasovagal Syncope International Study (VASIS) Investigators (2000) Dual-chamber pacing is efficacious in treatment of neurally-mediated tilt-positive cardioinhibitory syncope. Pacemaker versus no therapy: a multicentre randomized study. Circulation 102:294–299
Ammirati F, Colivicchi F, Santini M et al (2001) Permanent cardiac pacing versus medical treatment for the prevention of recurrent vasovagal syncope. Circulation 104:52–57
Connolly SJ, Sheldon R, Thorpe KE et al (2003) Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope (VPS II): a randomized trial. JAMA 289:2224–2229
Giada F, Raviele A, Menozzi C et al (2003) The Vasovagal Syncope and Pacing Trial (Synpace). A randomized, placebo-controlled study of permanent cardiac pacing for the treatment of recurrent vasovagal syncope. Pacing Clin Electrophysiol
Deharo JC, Peyre JP, Chalvidian T et al (2000) Continuous monitoring of an endocar-dial index of myocardial contractility during head-up tilt test. Am Heart J 139:1022–1030
Kurbaan AS, Erikson M, Petersen MEV et al (2000) Respiratory changes in vasovagal syncope. J Cardiovasc Electrophysiol 11:607–611
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2004 Springer-Verlag Italia
About this paper
Cite this paper
Giada, F., Raviele, A. (2004). To Pace or not to Pace for Neurally Mediated Syncope: Do We Know the Answer? A Positive View. In: Raviele, A. (eds) Cardiac Arrhythmias 2003. Springer, Milano. https://doi.org/10.1007/978-88-470-2137-2_85
Download citation
DOI: https://doi.org/10.1007/978-88-470-2137-2_85
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-2177-8
Online ISBN: 978-88-470-2137-2
eBook Packages: Springer Book Archive