INTRODUCTION: In this study, patients with rate hysteresis pacemakers implanted for vasovagal syncope were re-studied using serial tilt testing to determine whether, once triggered, pacing was more effective if the intervention rate was higher than the standard rate. METHODS AND RESULTS:Twenty patients (mean age 55.4 years, range 23-81, 14 male) were studied, with randomisation to either initial standard rate (80-90 beats/min) intervention, or to initial high rate (120 beats/min) intervention. Although 18 of the 20 reported complete abolition of syncope since pacing, only 8 patients could be objectively assessed. The respective mean time to tilt down after symptom onset with standard and high rate intervention was 193+/-234s and 185+/-143s, (P>0.05). CONCLUSION: Repeat tilt testing was only of limited value in assessing the benefit of pacing. There was no advantage with high rate intervention in delaying the loss of consciousness (or intolerable symptoms) after the initial onset of symptoms.
RCT Entities:
INTRODUCTION: In this study, patients with rate hysteresis pacemakers implanted for vasovagal syncope were re-studied using serial tilt testing to determine whether, once triggered, pacing was more effective if the intervention rate was higher than the standard rate. METHODS AND RESULTS: Twenty patients (mean age 55.4 years, range 23-81, 14 male) were studied, with randomisation to either initial standard rate (80-90 beats/min) intervention, or to initial high rate (120 beats/min) intervention. Although 18 of the 20 reported complete abolition of syncope since pacing, only 8 patients could be objectively assessed. The respective mean time to tilt down after symptom onset with standard and high rate intervention was 193+/-234s and 185+/-143s, (P>0.05). CONCLUSION: Repeat tilt testing was only of limited value in assessing the benefit of pacing. There was no advantage with high rate intervention in delaying the loss of consciousness (or intolerable symptoms) after the initial onset of symptoms.
Authors: G Gregoratos; M D Cheitlin; A Conill; A E Epstein; C Fellows; T B Ferguson; R A Freedman; M A Hlatky; G V Naccarelli; S Saksena; R C Schlant; M J Silka Journal: Circulation Date: 1998-04-07 Impact factor: 29.690
Authors: D G Benditt; R Sutton; M Gammage; T Markowitz; J Gorski; G Nygaard; J Fetter Journal: J Interv Card Electrophysiol Date: 1999-03 Impact factor: 1.900
Authors: Richard Sutton; Jelle S Y de Jong; Julian M Stewart; Artur Fedorowski; Frederik J de Lange Journal: Heart Rhythm Date: 2020-02-06 Impact factor: 6.343
Authors: Richard Sutton; Artur Fedorowski; Brian Olshansky; J Gert van Dijk; Haruhiko Abe; Michele Brignole; Frederik de Lange; Rose Anne Kenny; Phang Boon Lim; Angel Moya; Stuart D Rosen; Vincenzo Russo; Julian M Stewart; Roland D Thijs; David G Benditt Journal: Eur Heart J Date: 2021-05-01 Impact factor: 35.855