| Cardioinhibition during tilt testing identifies patients who may benefit from pacing. | |
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MedLine Citation:
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PMID: 11139925 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study examined whether the various hemodynamic collapse patterns observed during tilt testing in patients with suspected neurocardiogenic syncope are relevant when planning therapy, particularly whether a predominantly cardioinhibitory response predicts a beneficial response from pacing. METHODS: The effects of temporary atrioventricular (A-V) sequential pacing were studied during tilt testing in 34 patients 48.2 +/- 18.5 years of age. The patient population was divided into a cardioinhibitory group (VASIS classes 2A and 2B) or mixed group (VASIS classes 1 and 3) according to their response to baseline tilt testing. The test was then repeated during A-V pacing with rate hysteresis. A positive response to A-V pacing was defined as a > or = 30-second increase between onset of symptoms and syncope, or mitigation of symptoms compared with the baseline tilt test. RESULTS: The study protocol was not successfully completed in three patients. Among the remaining 31 patients, a baseline cardioinhibitory response was observed in 17, and a mixed response in 14 patients. A-V sequential pacing was successful in 13 of 17 patients with a cardioinhibitory response versus 5 of 14 patients with a mixed response (P = 0.024). CONCLUSION: The presence of a predominantly cardioinhibitory collapse pattern (VASIS 2A and 2B) during baseline tilt testing doubled the likelihood of successful temporary A-V sequential pacing, and may identify patients with neurocardiogenic syncope most likely to benefit from permanent dual chamber pacing. |
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Authors:
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A S Kurbaan; A C Franzén; D Heaven; G Mathur; T J Bowker; M Petersen; R Sutton |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 23 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2000 Nov |
Date Detail:
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Created Date: 2001-01-03 Completed Date: 2001-02-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1792-4 Citation Subset: IM |
Affiliation:
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Department of Cardiology, London Chest Hospital, Bonner Road, London E2 9SX, United Kingdom. a_kurbaan@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure Cardiac Pacing, Artificial* Female Heart / physiopathology* Heart Rate Humans Male Middle Aged Predictive Value of Tests Syncope, Vasovagal / classification, diagnosis*, therapy* Tilt-Table Test* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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