We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
DDD Pacing with Rate Drop Response Function Versus DDI with Rate Hysteresis Pacing for Cardioinhibitory Vasovagal Syncope.
- Authors
Ammirati, Fabrizio; Colivicchi, Furio; Toscano, Salvatore; Pandozi, Claudio; Laudadio, Maria Teresa; de Seta, Francesco; Santini, Massimo
- Abstract
Background: The effectiveness of cardiac pacing in preventing vasovagal syncope remains controversial. However, DDI pacing with rate hysteresis has been reported to prevent the recurrence of cardioinhibitory vasovagal syncope in up to 35% of affected subjects and to reduce the overall incidence of syncopal episodes in the others. Recently, DDD pacing with a new promising rate drop response function (Medtronic Thera-I model 7960) has become available in clinical practice. Aim of the study: The aim of the present open trial was to test the effectiveness of this new pacing modality in patients with cardioinhibitory vasovagal syncope. Study population and methods: The study population included 20 patients (12 males and 8 females; mean age 61.1 ± 14 yrs) with recurrent syncope (mean number of prior episode = 6.8, range 5-11) and cardioinhibitory responses during two head-up tilt tests: the first diagnostic and the second during drug therapy with either β-blockade or etilephrine. The study patients were randomized to receive either DDI pacing with rate hysteresis (8 patients) or DDD pacing with rate drop response function (11 patients). The head-up tilt test performed 1 month after pacemaker implantation was positive in 3 of 12 patients (25%) with DDD pacing with rate drop response function and in 5 of 8 patients (62.5%) with DDI pacing with rate hysteresis. The mean duration of follow-up was 17.7 ± 7.4 months. During follow-up no patients with a DDD pacemaker with rate drop response function had syncope, while 3 of 8 patients with a DDI pacemaker with rate hysteresis had recurrence of syncope (P < 0.05). Conclusions: These data suggest that DDD pacing with rate drop response function is effective in cardioinhibitory vasovagal syncope and may be preferable to DDI pacing with rate hysteresis.
- Subjects
SYNCOPE; CARDIAC pacing; CARDIAC pacemakers; IMPLANTED cardiovascular instruments; LOSS of consciousness; HYSTERESIS
- Publication
Pacing & Clinical Electrophysiology, 1998, Vol 21, Issue 11, p2178
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1998.tb01148.x