Document Detail


DDDR pacing driven by contractility versus DDI pacing in vasovagal syncope: a multicenter, randomized study.
MedLine Citation:
PMID:  12687864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent clinical trials have shown that selected patients with recurrent vasovagal syncope (VVS) may benefit from permanent cardiac pacing. In a previous study using head-up tilt testing (HUT) the authors demonstrated that the increase in sympathetic activity preceding syncope could be sensed by a microaccelerometer located in the tip of a ventricular pacing lead and used to drive a rate adaptive pacer. They compared in a single blind randomized crossover study, DDDR pacing driven by this system, with conventional DDI pacing in patients with recurrent VVS. Twenty-three patients (age 61.8 +/- 15.2 years, 19 men) with recurrent VVS were enrolled at seven European centers and underwent implantation of a "MiniLivingD/Best" pacing system. Inclusion criteria were (1) > 6 cumulative syncopal episodes or > or = 1 syncope within 6 months of a positive HUT, and (2) a positive HUT with bradycardia. Using a crossover study design, the pacemakers were randomly programmed for two successive periods of 6 months to DDDR or DDI mode. The numbers of episodes of syncope and presyncope, and quality-of-life (QOL), were assessed at the end of each period. During the 6 months before implant, the mean number of syncopal episodes per patient was 3.2 +/- 9. During pacing in the DDDR mode, 0.09 +/- 0.29 syncope/presyncope per patient was observed, while during the DDI period 0.48 +/- 0.73 episodes per patient were reported (P < 0.05). QOL scores were 77.40 +/- 11.32 in the DDDR mode versus 74.45 +/- 14.59 in the DDI mode (NS). In patients with recurrent VVS, symptomatic recurrences were less frequent during contractility-driven DDDR pacing, than during DDI pacing. QOL was similar in the two pacing modes.
Authors:
Jean-Claude Deharo; Alberto Borri Brunetto; Fulvio Bellocci; Lorella Barbonaglia; Eraldo Occhetta; Lorella Fasciolo; Maurizio Bocchiardo; Giorgio Rognoni
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-04-11     Completed Date:  2003-07-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  447-50     Citation Subset:  IM    
Affiliation:
Cardiology Dept., Sainte-Marguerite University Hospital of Marseilles, 270 Bd Sainte-Marguerite, 13008 Marseille, France. jean-claude.deharo@ap-hm.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiac Pacing, Artificial / methods*
Cross-Over Studies
Female
Humans
Male
Middle Aged
Myocardial Contraction
Pacemaker, Artificial*
Quality of Life
Recurrence
Single-Blind Method
Syncope, Vasovagal / physiopathology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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