| Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE). | |
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MedLine Citation:
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PMID: 11691528 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of the study was to determine whether cardiac pacing reduces falls in older adults with cardioinhibitory carotid sinus hypersensitivity (CSH). BACKGROUND: Cardioinhibitory carotid sinus syndrome causes syncope, and symptoms respond to cardiac pacing. There is circumstantial evidence for an association between falls and the syndrome. METHODS: A randomized controlled trial was done of consecutive older patients (>50 years) attending an accident and emergency facility because of a non-accidental fall. Patients were randomized to dual-chamber pacemaker implant (paced patients) or standard treatment (controls). The primary outcome was the number of falls during one year of follow-up. RESULTS: One hundred seventy-five eligible patients (mean age 73 +/- 10 years; 60% women) were randomized to the trial: pacemaker 87; controls 88. Falls (without loss of consciousness) were reduced by two-thirds: controls reported 669 falls (mean 9.3; range 0 to 89), and paced patients 216 falls (mean 4.1; range 0 to 29). Thus, paced patients were significantly less likely to fall (odds ratio 0.42; 95% confidence interval: 0.23, 0.75) than were controls. Syncopal events were also reduced during the follow-up period, but there were much fewer syncopal events than falls-28 episodes in paced patients and 47 in controls. Injurious events were reduced by 70% (202 in controls compared to 61 in paced patients). CONCLUSIONS: There is a strong association between non-accidental falls and cardioinhibitory CSH. These patients would not usually be referred for cardiovascular assessment. Carotid sinus hypersensitivity should be considered in all older adults who have non-accidental falls. |
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Authors:
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R A Kenny; D A Richardson; N Steen; R S Bexton; F E Shaw; J Bond |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 38 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2001-11-05 Completed Date: 2001-12-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1491-6 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Investigation Unit, Royal Victoria Infirmary/MRC Development Centre for Clinical Brain Ageing, Newcastle General Hospital, Newcastle Upon Tyne, United Kingdom. r.a.kenny@ncl.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Accidental Falls
/
prevention & control*,
statistics & numerical data* Activities of Daily Living Age Factors Aged Aged, 80 and over Algorithms Cardiac Pacing, Artificial / standards* Decision Trees Emergency Service, Hospital / utilization Female Follow-Up Studies Geriatric Assessment Humans Logistic Models Male Mass Screening Pacemaker, Artificial / standards* Recurrence Referral and Consultation Risk Factors Syncope / complications*, prevention & control* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2001 Nov 1;38(5):1497
[PMID:
11691529
]
ACP J Club. 2002 Jul-Aug;137(1):8 [PMID: 12093207 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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