Document Detail

Cardioinhibition during tilt testing identifies patients who may benefit from pacing.
MedLine Citation:
PMID:  11139925     Owner:  NLM     Status:  MEDLINE    
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.
A S Kurbaan; A C Franzén; D Heaven; G Mathur; T J Bowker; M Petersen; R Sutton
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  23     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-03     Completed Date:  2001-02-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1792-4     Citation Subset:  IM    
Department of Cardiology, London Chest Hospital, Bonner Road, London E2 9SX, United Kingdom.
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MeSH Terms
Blood Pressure
Cardiac Pacing, Artificial*
Heart / physiopathology*
Heart Rate
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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