The Current Indication for Pacemaker in Patients with Cardioinhibitory Vasovagal Syncope

Abstract

The most frequent cause of syncope is vasovagal reflex. It is associated with worse quality of life, depression, fatigue and physical injury. Recurrence of vasovagal syncope is an aggravating, reaching the rate of 69%. Initial step and pharmacological treatment may not work, especially in patients with recurrent syncope without prodrome. These patients can present cardioinhibitory response with asystole. Studies were designed to analyses the effectiveness of pacemaker for prevention of syncope. In this review, nonrandomized clinical trials, open-label randomized, double-blind randomized, placebo-controlled, and studies based on tilt test or Implantable Loop Recorder findings will be discussed.

Venous Capacitance and Venous Return in Young Adults with Typical Vasovagal Syncope: A Cross-Sectional Study

“…and its prevalence may be as high as 69% in certain populations. 4 It has been estimated that nearly one-third of a population of syncopal patients experienced injury, with 4.7% classified as severe. 5 The economic burden is approximately US$2.4 billion per year in the US alone.…”

“…VVS carries a substantial risk of serious injury and has a high rate of recurrence. It also imposes a substantial economic burden associated with hospitalization due to trauma 4–6. The diagnostic yield of emergency room visits for syncope is often poor; patients receive minimal care and 39%–50% are discharged from the hospital without a diagnosis 36.…”

“…It also imposes a substantial economic burden associated with hospitalization due to trauma. [4][5][6] The diagnostic yield of emergency room visits for syncope is often poor; patients receive minimal care and 39%-50% are discharged from the hospital without a diagnosis. 36 One aim of this study was to develop a tool that could help identify characteristics of high-risk individual, so they could be taught management techniques, such as CPM, to minimize the possibility of traumatic injury should symptoms of impending VVS develop; thereby, decreasing the financial and healthcare burdens.…”

“…Research suggests that syncope can occasionally be aborted by counterpressure maneuvers (CPM), which increase venous return (VR), counteracting the effects of vasodilation 3. VVS is the most common cause of recurrent syncope, and its prevalence may be as high as 69% in certain populations 4. It has been estimated that nearly one-third of a population of syncopal patients experienced injury, with 4.7% classified as severe 5.…”