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Permanent pacing for recurrent vasovagal syncope: New answers or just more questions?
Tolga Aksu1, John Mandrola2, Satish R Raj3
1Department of Cardiology, University of Health Sciences, Kocaeli Derince Education and Research Hospital, Kocaeli 41500, Turkey.
Abstract:
Vasovagal syncope (VVS) is a clinical condition related to bradycardia (cardioinhibitory response) and/or hypotension (vasodepressor response), likely mediated by parasympathetic overactivity and sympathetic withdrawal. Although clinical presentation is usually related to a self-limited event, frequent episodes or events without prodrome might be debilitating. There are limited medical therapies proven effective in randomized clinical trials. In patients not responsive to standard therapy, permanent pacemaker therapy may be suggested. However, the role of cardiac pacing for the prevention of syncope recurrences remains controversial due to difficulties to exclude potential role of the vasodepressor component during the episode.
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