[Dual chamber pacing for vasovagal syncope]

Area of Science:

• Cardiology
• Electrophysiology
• Neurology

Context:

• Vasovagal syncope (VVS) is a common condition often triggered by autonomic dysfunction.
• Recurrent syncope can significantly impact quality of life and pose safety risks.
• Conventional treatments may not be effective for all VVS patients, particularly those with severe heart inhibition.

Purpose:

• To evaluate the efficacy of DDD pacing, specifically with rate-drop response (RDR) function, in preventing vasovagal syncope.
• To assess the impact of DDD pacing on syncope recurrence and pre-syncope symptoms in a cohort of VVS patients.

Summary:

• Eleven patients diagnosed with VVS underwent DDD pacemaker implantation, with 9 featuring RDR function.
• Following implantation, all patients were free from syncope, and 4 reported only mild pre-syncope discomfort.
• Tilt table testing post-implantation confirmed that RDR pacing effectively prevented syncope by initiating pacing upon heart rate drop.

Impact:

• DDD pacing with RDR function offers an effective therapeutic strategy for VVS patients experiencing recurrent syncope and severe heart inhibition.
• This intervention demonstrates potential to significantly improve patient outcomes and reduce syncope-related morbidity.
• The findings support the consideration of pacemaker implantation for refractory VVS cases with specific hemodynamic profiles.