[Permanent heart pacing in treatment of cardioinhibitory vasovagal syncope (case report)]

Vasovagal syncope is a complex syndrome in which specific methods of treatment rarely are related to clinical success. Since it turned out that some patients with neurocardiogenic syncope were resistant to offered pharmacotherapy, cardiac pacing has been used as the alternative way of long-term therapy. Successive studies, which have estimated clinical efficacy of permanent cardiac pacing, indicate that such method of treatment may reduce symptoms revealed by vasovagal reflex. Nevertheless the optimal pacing mode has not been established yet. It is known that single chamber VVI pacing is not a good and effective method whereas dual chamber DDI pacing with rate hysteresis seems to be very promising in treatment of people suffering from malignant cardioinhibitory vasovagal syncope. DDD pacing with rate drop response, search and scan functions recently has been available to these patients. The results of the North American Vasovagal Pacemaker Study, as well as some casuistic observations referring to patients with vasovagal syndrome, show very high clinical efficacy of dual chamber pacing with mentioned new functions. We present a case of patient with cardioinhibitory vasovagal syncope who was successfully treated by permanent DDD pacing with search and scan hysteresis.