Publication
Cardiac Pacing in Severe Recurrent Reflex Syncope and Tilt-Induced Asystole
| dc.contributor.author | Brignole, M | |
| dc.contributor.author | Russo, V | |
| dc.contributor.author | Arabia, F | |
| dc.contributor.author | Oliveira, MM | |
| dc.contributor.author | Pedrote, A | |
| dc.contributor.author | Aerts, A | |
| dc.contributor.author | Rapacciuolo, A | |
| dc.contributor.author | Boveda, S | |
| dc.contributor.author | Deharo, JC | |
| dc.contributor.author | Maglia, G | |
| dc.contributor.author | Nigro, G | |
| dc.contributor.author | Giacopelli, D | |
| dc.contributor.author | Gargaro, A | |
| dc.contributor.author | Tomaino, M | |
| dc.date.accessioned | 2021-10-13T14:34:24Z | |
| dc.date.available | 2021-10-13T14:34:24Z | |
| dc.date.issued | 2021 | |
| dc.description.abstract | 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. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Eur Heart J. 2021 Feb 1;42(5):508-516. | pt_PT |
| dc.identifier.doi | 10.1093/eurheartj/ehaa936. | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/3879 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | European Society of Cardiology | pt_PT |
| dc.subject | HSM CAR | pt_PT |
| dc.subject | Adult | pt_PT |
| dc.subject | Cardiac Pacing, Artificial* | pt_PT |
| dc.subject | Humans | pt_PT |
| dc.subject | Heart Arrest* / etiology | pt_PT |
| dc.subject | Heart Arrest* / therapy | pt_PT |
| dc.subject | Reflex | pt_PT |
| dc.subject | Syncope / etiology | pt_PT |
| dc.subject | Syncope / therapy | pt_PT |
| dc.subject | Tilt-Table Test | pt_PT |
| dc.subject | Treatment Outcome | pt_PT |
| dc.title | Cardiac Pacing in Severe Recurrent Reflex Syncope and Tilt-Induced Asystole | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 516 | pt_PT |
| oaire.citation.startPage | 508 | pt_PT |
| oaire.citation.title | European Heart Journal | pt_PT |
| oaire.citation.volume | 42 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |
Files
Original bundle
1 - 1 of 1