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How and when to pace in vasovagal syncope
1Royal Brompton Hospital, London, United Kingdom. R.Hawthorn@rbh.nthames.nhs.uk
Journal of Cardiovascular Electrophysiology
|February 15, 2002
Summary
Pacing shows clear benefit for vasovagal syncope patients, according to two trials. Dual-chamber pacemakers with rate hysteresis are recommended for improving outcomes in these patients.
Area of Science:
- Cardiology
- Neurology
Background:
- Vasovagal syncope is a common cause of fainting.
- Current management often involves non-device therapies with limited efficacy.
Purpose of the Study:
- To discuss the indications for pacemaker implantation in vasovagal syncope.
- To review the existing literature on the efficacy of pacing for vasovagal syncope.
Main Methods:
- Review of randomized controlled trials comparing pacing to non-device therapy.
- Analysis of literature on pacemaker settings and outcomes in vasovagal syncope.
Main Results:
- Two small randomized controlled trials demonstrate a clear benefit of pacing.
- The precise mechanism of pacing benefit remains to be fully elucidated.
- Dual-chamber pacing with rate hysteresis is suggested as an effective mode.
Conclusions:
- Pacing is an effective therapy for select patients with vasovagal syncope.
- Further research is needed to optimize pacemaker therapy delivery for vasovagal syncope.