Radovanović Nikola N, Kirćanski Bratislav, Raspopović Srdjan, Pavlović Siniša U, Jovanović Velibor, Milašinović Goran
Srp Arh Celok Lek. 2016 Nov-Dec;144(11-12):597-601.
Vasovagal syncope is the most common type of reflex syncope. Efficacy of cardiac pacing in this indication has not been the subject of many studies and pacemaker therapy in patients with vasovagal syncope is still controversial.
This study aimed to assess the efficacy and safety of pacing therapy in treatment of patients with vasovagal syncope, to determine contribution of new therapeutic models in increasing its success, and to identify risk factors associated with a higher rate of symptoms after pacemaker implantation.
A retrospective study included 30 patients with pacemaker implanted due to vasovagal syncope in the Pacemaker Center, Clinical Center of Serbia, between November 2003 and June 2014. Head-up tilt test was performed to diagnose vasovagal syncope. Patients with cardioinhibitory and mixed type of disease were enrolled in the study.
Mean age was 48.1 ± 11.1 years and 18 (60%) patients were men. Mean follow-up period was 5.9 ± 3.0 years. Primarily, implantable loop recorder was implanted in 10 (33.3%) patients. Twenty (66.7%) patients presented cardioinhibitory and 10 (33.3%) mixed type of vasovagal syncope. After pacemaker implantation, 11 (36.7%) patients had syncope. In multiple logistic regression analysis we showed that syncope is statistically more likely to occur after pacemaker implantation in patients with mixed type of vasovagal syncope (p = 0.018). There were two (6.7%) perioperative surgical complications.
Pacemaker therapy is a safe treatment for patients with vasovagal syncope, whose efficacy can be improved by strict selection of patients. We showed that symptoms occur statistically more often in patients with mixed type of disease after pacemaker implantation.
血管迷走性晕厥是最常见的反射性晕厥类型。心脏起搏在该适应症中的疗效尚未成为众多研究的主题，血管迷走性晕厥患者的起搏器治疗仍存在争议。
本研究旨在评估起搏治疗对血管迷走性晕厥患者的疗效和安全性，确定新治疗模式对提高其成功率的贡献，并识别与起搏器植入后症状发生率较高相关的危险因素。
一项回顾性研究纳入了2003年11月至2014年6月期间在塞尔维亚临床中心起搏器中心因血管迷走性晕厥植入起搏器的30例患者。进行直立倾斜试验以诊断血管迷走性晕厥。心脏抑制型和混合型疾病患者纳入研究。
平均年龄为48.1±11.1岁，18例（60%）患者为男性。平均随访期为5.9±3.0年。最初，10例（33.3%）患者植入了植入式环路记录器。20例（66.7%）患者表现为心脏抑制型血管迷走性晕厥，10例（33.3%）为混合型。起搏器植入后，11例（36.7%）患者发生晕厥。在多因素逻辑回归分析中，我们显示混合型血管迷走性晕厥患者起搏器植入后晕厥发生的统计学可能性更高（p = 0.018）。有2例（6.7%）围手术期手术并发症。
起搏器治疗对血管迷走性晕厥患者是一种安全的治疗方法，通过严格选择患者可提高其疗效。我们显示混合型疾病患者起搏器植入后症状发生的统计学频率更高。
