Document Detail

Follow-up of asystolic episodes in patients with cardioinhibitory, neurally mediated syncope and VVI pacemaker.
MedLine Citation:
PMID:  8237805     Owner:  NLM     Status:  MEDLINE    
The occurrence rate of spontaneous asystolic episodes during long-term follow-up in patients with abnormal asystolic responses induced by means of vasovagal maneuvers was evaluated. The heart rate of 23 patients (mean age 64 +/- 12 years; 6 women and 17 men) affected by neurally mediated syncope (mean 4.3 +/- 4.9 episodes) was continuously monitored by a specially designed implanted pacemaker able to detect and store in its memory all asystolic episodes lasting 3 to 6 or > 6 seconds. Asystolic, neurally mediated syncope was diagnosed when a reflex asystole of > 3 seconds was induced during carotid sinus massage (n = 22), eyeball compression test (n = 3) or head-up tilt test (n = 2). During a total of 357 months (mean 15 +/- 7) of monitoring, asystolic episodes occurred in 17 patients (74%): 1,765 episodes of 3- to 6-second (median 3) duration occurred in 14 patients, and 47 episodes of > 6-second (median 2) duration occurred in 11. The actuarial estimates of occurrence of asystolic episodes of > 3 and > 6 seconds were 82 and 53%, respectively, after 2 years of follow-up. Only 12 episodes of 3 to 6 seconds (0.7%), and 20 episodes of > 6 seconds (43%) resulted in presyncopal or syncopal symptoms. Thus, an asystolic response to vasovagal maneuvers predicts the occurrence of spontaneous asystolic episodes during follow-up. With few exceptions, spontaneous episodes are asymptomatic and their incidence is low.
C Menozzi; M Brignole; G Lolli; N Bottoni; D Oddone; L Gianfranchi; G Gaggioli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  72     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-12-17     Completed Date:  1993-12-17     Revised Date:  2007-09-04    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1152-5     Citation Subset:  AIM; IM; S    
Laboratory of Electrophysiology and Pacing, Ospedale S. Maria Nuova, Reggio Emilia, Italy.
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MeSH Terms
Aged, 80 and over
Electrocardiography, Ambulatory
Follow-Up Studies
Heart Arrest / etiology,  physiopathology*
Heart Rate / physiology
Life Tables
Middle Aged
Pacemaker, Artificial*
Predictive Value of Tests
Prospective Studies
Syncope / complications,  physiopathology*,  therapy
Vagus Nerve / physiopathology*

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