Permanent pacemaker implantation in unexplained syncope patients with electrophysiology study-proven atrioventricular node disease

Hellenic Journal of Cardiology

Petros Arsenos¹  Christos-Konstantinos Antoniou²  Stefanos Archontakis³  George Karystinos³  Ilias Sotiropoulos³  Konstantinos Tsioufis³  Ioannis Doundoulakis³  Polychronis Dilaveris³  Dimitris Tsiachris³  Stergios Soulaidopoulos³  Voula Pylarinou³  Theodoros Gialernios³  Skevos Sideris³  Konstantinos A. Gatzoulis³  Panagiotis Xydis³  Ageliki Laina⁴  Charalambos Vlachopoulos⁴  Athanasios Kordalis⁴ 

[1] Corresponding author. 181 Dorieon str., P.O. Box 175, Drafi, Attica, 19009, Greece. Tel.: [phone].;Athens Heart Center, Athens Medical Center, Athens, Greece;First Department of Cardiology, National and Kapodistrian University, “Hippokration” Hospital, Athens, Greece;State Department of Cardiology, “Hippokration” Hospital, Athens, Greece;

关键词: syncope;    presyncope;    pacemaker;    electrophysiology study;    atrioventricular node disease;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective: Syncope, whose cause is unknown after an initial assessment, has an uncertain prognosis. It is critical to identify patients at the highest risk who may require a pacemaker and to identify the cause of recurrent syncope to prescribe proper therapy. The aim of this study was to evaluate the effect of permanent pacing on the incidence of syncope in patients with unexplained syncope and electrophysiology study (EPS)-proven atrioventricular (AV) node disease. Methods: This was an observational study based on a prospective registry of 236 consecutive patients (60.20 ± 18.66 years, 63.1% male, 60.04 ± 9.50 bpm) presenting with recurrent unexplained syncope attacks admitted to our hospital for invasive EPS. The decision to implant a permanent pacemaker was made in all cases by the attending physicians according to the results of the EPS. A total of 135 patients received the antibradycardia pacemaker (ABP), while 101 patients were declined. Results: The mean of reported syncope episodes was 1.97 ± 1.10 (or presyncope 2.17 ± 1.50) before they were referred for a combined EP-guided diagnostic and therapeutic approach. Over a mean follow-up of approximately 4 years (49.19 ± 29.58 months), the primary outcome event (syncope) occurred in 31 of 236 patients (13.1%), and 6 of 135 (4.4%) patients in the ABP group as compared to 25 of 101 (24.8%) in the no pacemaker group (p < 0.001). Conclusion: Among patients with a history of unexplained syncope, a set of positivity criteria for the presence of EPS-defined AV node disease identifies a subset of patients who will benefit from permanent pacing.

【 授权许可】

Unknown