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Browsing by Author "Boveda, S"

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  • Cardiac Pacing in Severe Recurrent Reflex Syncope and Tilt-Induced Asystole
    Publication . Brignole, M; Russo, V; Arabia, F; Oliveira, MM; Pedrote, A; Aerts, A; Rapacciuolo, A; Boveda, S; Deharo, JC; Maglia, G; Nigro, G; Giacopelli, D; Gargaro, A; Tomaino, M
    Aim: The benefit of cardiac pacing in patients with severe recurrent reflex syncope and asystole induced by tilt testing has not been established. The usefulness of tilt-table test to select candidates for cardiac pacing is controversial. Methods and results: We randomly assigned patients aged 40 years or older who had at least two episodes of unpredictable severe reflex syncope during the last year and a tilt-induced syncope with an asystolic pause longer than 3 s, to receive either an active (pacing ON; 63 patients) or an inactive (pacing OFF; 64 patients) dual-chamber pacemaker with closed loop stimulation (CLS). The primary endpoint was the time to first recurrence of syncope. Patients and independent outcome assessors were blinded to the assigned treatment. After a median follow-up of 11.2 months, syncope occurred in significantly fewer patients in the pacing group than in the control group [10 (16%) vs. 34 (53%); hazard ratio, 0.23; P = 0.00005]. The estimated syncope recurrence rate at 1 year was 19% (pacing) and 53% (control) and at 2 years, 22% (pacing) and 68% (control). A combined endpoint of syncope or presyncope occurred in significantly fewer patients in the pacing group [23 (37%) vs. 40 (63%); hazard ratio, 0.44; P = 0.002]. Minor device-related adverse events were reported in five patients (4%). Conclusion: In patients aged 40 years or older, affected by severe recurrent reflex syncope and tilt-induced asystole, dual-chamber pacemaker with CLS is highly effective in reducing the recurrences of syncope. Our findings support the inclusion of tilt testing as a useful method to select candidates for cardiac pacing.
    2021Journal article Open access Show more
  • EHRA Expert Consensus Statement and Practical Guide on Optimal Implantation Technique for Conventional Pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)
    Publication . Burri, H; Starck, C; Auricchio, A; Biffi, M; Burri, M; D’Avila, A; Deharo, JC; Glikson, M; Israel, C; Lau, CP; Leclercq, C; Love, C; Nielsen, J; Vernooy, K; Dagres, N; Boveda, S; Butter, C; Marijon, E; Braunschweig, F; Mairesse, G; Gleva, M; Defaye, P; Zanon, F; Lopez-Cabanillas, N; Guerra, J; Vassilikos, V; Oliveira, M
    With the global increase in device implantations, there is a growing need to train physicians to implant pacemakers and implantable cardioverter-defibrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to fill the gap by setting standards for device implantation.
    2021-07Journal article Open access Show more