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[Neurocardiogenic syncopes in patients with implanted pacemakers]
1Medizinische Klinik, Kreiskrankenhaus Reutlingen Akademisches Lehrkrankenhaus, Universität Tübingen. mwkeim@aol.com
Deutsche Medizinische Wochenschrift (1946)
|September 11, 1999
Summary
Patients experiencing syncope, especially when sitting or standing, should undergo the tilting table test to diagnose neurocardiogenic syncope (NS). This can help avoid unnecessary pacemaker implantation, as medication is often effective for NS.
Area of Science:
- Cardiology
- Neuroscience
Context:
- The tilting table test is increasingly used for diagnosing neurocardiogenic syncope (NS).
- Pacemaker implantation is a common treatment for bradycardic arrhythmias and asystole causing syncope.
Purpose:
- To evaluate the efficacy of the tilting table test in identifying neurocardiogenic syncope in patients who had previously received pacemakers for recurrent syncopal episodes.
- To highlight alternative treatments for neurocardiogenic syncope when pacemaker implantation is inappropriate.
Summary:
- Eight patients with pacemakers for various bradycardic conditions continued to experience syncope. The tilting table test confirmed neurocardiogenic syncope in all cases, with no pacemaker malfunction.
- Seven patients were successfully treated with medications such as theophylline, metoprolol, or disopyramide, becoming symptom-free during tilt table testing.
Impact:
- Emphasizes the importance of the tilting table test to differentiate neurocardiogenic syncope from other causes, preventing unnecessary pacemaker implantation.
- Demonstrates that pharmacological management is effective for the majority of neurocardiogenic syncope patients, reserving pacemaker implantation for refractory cases.