Raj Satish R, Sheldon Robert S
Cardiovascular Research Group, University of Calgary, Calgary, Alberta, Canada.
Curr Opin Cardiol. 2003 Jan;18(1):47-52. doi: 10.1097/00001573-200301000-00007.
Patients with frequent vasovagal syncope have a poor quality of life and often resist treatment with standard pharmacologic approaches. Clinical vasovagal syncope may be associated with some degree of bradycardia. Studies of temporary pacing during tilt table tests showed that pacing prevented syncope in a little more than half of patients who developed a vasovagal response. Six open-label studies of permanent pacing show that permanent pacemaker therapy is associated with substantial improvement over medical therapy. The roles of specific pacemaker modes have not been determined, although there is some evidence that rate-drop responsiveness helps. The second Vasovagal Pacemaker Study will quantify the true benefits of pacing for vasovagal syncope and assess the role of rate-drop response algorithms.
频发血管迷走性晕厥患者生活质量较差，且常常抗拒标准药物治疗方法。临床血管迷走性晕厥可能与一定程度的心动过缓有关。倾斜试验期间临时起搏的研究表明，起搏仅能防止略多于一半出现血管迷走反应的患者发生晕厥。六项关于永久起搏的开放标签研究表明，永久起搏器治疗与药物治疗相比有显著改善。尽管有证据表明频率骤降反应性有帮助，但特定起搏器模式的作用尚未确定。第二项血管迷走性起搏器研究将量化起搏对血管迷走性晕厥的真正益处，并评估频率骤降反应算法的作用。
