心脏抑制型血管迷走性晕厥患者起搏器的当前适应证
The Current Indication for Pacemaker in Patients with Cardioinhibitory Vasovagal Syncope.
作者信息
da Silva Rose Mary Ferreira Lisboa
机构信息
Department of Internal Medicine, Faculty of Medicine, UFMG-Federal University of Minas Gerais, Belo Horizonte, Brazil.
出版信息
Open Cardiovasc Med J. 2016 Aug 26;10:179-87. doi: 10.2174/1874192401610010179. eCollection 2016.
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.
晕厥最常见的原因是血管迷走神经反射。它与生活质量下降、抑郁、疲劳和身体损伤有关。血管迷走性晕厥的复发情况较为严重，复发率达69%。初始步骤和药物治疗可能无效，尤其是对于无前驱症状的复发性晕厥患者。这些患者可能会出现心脏抑制反应伴心搏停止。开展了多项研究以分析起搏器预防晕厥的有效性。在本综述中，将讨论非随机临床试验、开放标签随机试验、双盲随机试验、安慰剂对照试验以及基于倾斜试验或植入式循环记录仪结果的研究。
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