Abstract:
:The indication for permanent pacemaker remains controversial in malignant neurocardiogenic syncope. A highly reproducible prolonged pause during a repeat head-up tilt-table testing may identify a subgroup of neurally mediated syncope with a prominent and consistent cardioinhibitory component. Seven patients (3 females) with a mean age of 30 years (23-44 years) were diagnosed to have malignant neurocardiogenic -syncope; all are classified according to the Vasovagal Syncope International Study as 2B type, with observed sinus pauses ranged from 3 s to 26 s of which only 1 demonstrated a reproducible sinus pause. No recurrence of syncope was clinically observed in patients during the follow-up period. Of 6 patients treated non--pharmacologically, one required a beta-blocker and none required a permanent pacemaker. Prolonged asystole manifest during head-up tilt-table testing is a poorly reproducible phenomenon and permanent pacemaker implantation in malignant neurocardiogenic syncope should not be a first line therapy.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Omar AR,Ng KS,Ng WL,Sutandar Adoi
10.1111/j.1444-0903.2004.00626.xkeywords:
subject
Has Abstractpub_date
2004-08-01 00:00:00pages
504-6issue
8eissn
1444-0903issn
1445-5994pii
IMJ626journal_volume
34pub_type
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