Meta-analysis of Pacemaker Therapy in Patients With Neurocardiogenic Syncope

Approximately one-half of the population will have a syncopal event, mostly neurocardiogenic, a term which includes carotid sinus hypersensitivity, situational, and vasovagal syncope.1 Although patients with the cardioinhibitory subtype might benefit from pacemaker therapy, current 2017 United State...

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Bibliographic Details
Published in:The American journal of cardiology 2021-06, Vol.149, p.159-160
Main Authors: Kheiri, Babikir, Abdelazeem, Basel, Osman, Mohammed, Dalouk, Khidir, Stecker, Eric, Raitt, Merritt H, Henrikson, Charles A., Nazer, Babak
Format: Article
Language:English
Subjects:
Carotid sinus
Clinical trials
Fainting
Hypersensitivity
Meta-analysis
Pacemakers
Syncope
Therapy
Vasovagal syncope
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Summary:Approximately one-half of the population will have a syncopal event, mostly neurocardiogenic, a term which includes carotid sinus hypersensitivity, situational, and vasovagal syncope.1 Although patients with the cardioinhibitory subtype might benefit from pacemaker therapy, current 2017 United States guidelines caution against the use of pacemaker therapy due to the lack of large, randomized double blinded studies.1 Therefore, we conducted a meta-analysis of all randomized controlled trials (RCTs) with double-blinded designs to evaluate the role of cardiac pacing in this vulnerable population. Inclusion criteria included minimum of 2 to 6 syncope episodes, 3 trials required positive tilt-table testing, and 2 required asystolic pauses >3 seconds. [...]among patients with recurrent neurocardiogenic syncope, pacemaker therapy is associated with an over 50% reduction in syncope recurrence.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2021.03.015