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Permanent cardiac pacing to prevent vasovagal syncope
Satish R Raj1, Robert S Sheldon
1Cardiovascular Research Group, University of Calgary, Calgary, Alberta, Canada.
Current Opinion in Cardiology
|January 16, 2002
Summary
Permanent pacemaker implantation offers significant benefits for patients with frequent vasovagal syncope, improving quality of life when standard treatments fail. Further studies will confirm pacing
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Frequent vasovagal syncope significantly impairs patient quality of life.
- Standard pharmacologic treatments are often ineffective.
- Vasovagal syncope may be linked to bradycardia, suggesting pacing as a potential intervention.
Purpose of the Study:
- To evaluate the efficacy of permanent pacemaker therapy for managing vasovagal syncope.
- To assess the role of specific pacemaker modes, including rate-drop response algorithms.
Main Methods:
- Review of existing studies on temporary and permanent pacemaker implantation for vasovagal syncope.
- Analysis of open-label studies assessing pacemaker therapy outcomes.
- The upcoming Vasovagal Pacemaker Study (VPS) will provide further quantification.
Main Results:
- Temporary pacing during tilt table tests prevented syncope in over 50% of patients.
- Permanent pacemaker therapy demonstrated substantial improvement compared to medical management in open-label studies.
- Rate-drop responsiveness may offer additional benefits, though specific modes require further investigation.
Conclusions:
- Permanent pacemaker therapy is a promising treatment for refractory vasovagal syncope.
- Further research, including the VPS, is needed to fully elucidate the benefits and optimal pacing strategies for vasovagal syncope.