| Incidence and predictors of syncope in paced patients with sick sinus syndrome. | |
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MedLine Citation:
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PMID: 1279599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In spite of a normal pacemaker function, syncope still occurs in some patients with sick sinus syndrome (SSS). Causes often remain unknown. To identify predictors and etiologies of this bothersome symptom, we studied 507 patients who received atrial, ventricular, and dual-chamber pacemakers for SSS. During a mean follow-up of 62 +/- 38 months, actuarial incidence of syncope was 3% at 1 year, 8% at 5 years, and 13% at 10 years. Causes were vasovagal (18%), orthostatic hypotension (25.5%), rapid atrial tachyarrhythmias (11.5%), ventricular tachycardia (5%), acute myocardial ischemia (2.5%), and pacemaker/lead malfunction (6.5%). In 13 patients (29.5%), syncope remained unexplained. The only preimplant predictor for syncope was syncope as primary indication for pacemaker implant. Electrocardiographic correlation with bradycardia was not a predictor of relief of syncope during the follow-up. In conclusion: (1) syncope in paced patients with SSS has multiple etiologies and may be multifactorial; (2) the only predictor of syncope after pacemaker implant is the occurrence of preimplant syncope as the main indication for pacing; (3) extensive Holter monitoring is not useful to document bradycardiac origin of syncope nor to predict its recurrence; (4) SSS probably overlaps with other entities such as autonomic dysfunction, vasovagal syncope, carotid sinus hypersensitivity, and venous pooling, which would provide an explanation for recurrent syncope in patients with normal pacemaker function. |
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Authors:
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E B Sgarbossa; S L Pinski; F J Jaeger; R G Trohman; J D Maloney |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 15 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 1992 Nov |
Date Detail:
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Created Date: 1992-12-16 Completed Date: 1992-12-16 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: 2055-60 Citation Subset: IM |
Affiliation:
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Dept. of Cardiology, Cleveland Clinic Foundation, OH 44195. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Actuarial Analysis Aged Cardiac Pacing, Artificial / methods Electrocardiography, Ambulatory Female Follow-Up Studies Humans Incidence Male Pacemaker, Artificial* Risk Factors Sick Sinus Syndrome / complications, therapy* Syncope / epidemiology*, etiology Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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