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Syncope in Patients with Cardiac Pacemakers.
Eduardo Arrais Rocha1, Gisele Schineider Cunha1, Aline Bezerra Tavares1
1Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Brazilian Journal of Cardiovascular Surgery
|February 17, 2021
Summary
Diagnosing syncope in pacemaker patients is challenging. While neurally mediated syncope is common, cardiac causes and pacemaker failure pose significant risks, with NYHA Class II patients at higher risk.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- Syncope diagnosis in pacemaker patients presents unique challenges due to increased morbidity and mortality risks.
- Prompt and accurate etiological determination is crucial for effective treatment in this population.
Purpose of the Study:
- To investigate the causes and predictive factors of syncope in patients with cardiac pacemakers.
- To evaluate diagnostic methods for syncope in pacemaker recipients.
Main Methods:
- Standardized questionnaires, endocavitary electrograms, and other etiological tests were employed.
- Statistical analysis included Mann-Whitney U, Chi-squared, Fisher's exact tests, and logistic regression for multivariate analyses (P<0.05).
Main Results:
- Of 95 pacemaker patients, 47 experienced syncope. Neurally mediated syncope was most frequent (48.9%), followed by cardiac causes (17%) and pacemaker failure (8.5%).
- New York Heart Association (NYHA) Functional Class II was identified as a significant predictive factor for syncope (P<0.01).
Conclusions:
- Neurally mediated syncope is common in pacemaker patients, but life-threatening causes necessitate thorough investigation.
- Stored electrogram analysis and tilt table testing were identified as optimal diagnostic tools.
- NYHA Functional Class II status indicates an elevated risk for syncope in this cohort.
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