Open AccessRole of permanent cardiac pacing for vasovagal syncope
Author(s) -
Sumiyoshi Masataka
Publication year - 2014
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2014.04.009
Subject(s) - medicine , vasovagal syncope , cardiac pacing , implantable loop recorder , syncope (phonology) , randomized controlled trial , cardiology , atrial fibrillation
The role of pacemaker therapy for vasovagal syncope (VVS) is still controversial. The ISSUE 3 study led to reappraisal of pacing therapy (using DDD pacing with the rate‐drop response algorithm) for reducing syncope recurrence in a highly selected patient group (age, ≥40 years) with asystolic VVS clinically documented by implantable loop recorder. However, the role of pacemaker treatment for young (age, <40 years) VVS patients remains to be established. Psychological sequelae and the burden of the long‐term implanted device should be considered. DDD pacing with closed‐loop stimulation seems to be a promising algorithm; however, we need more data to determine the best pacing algorithm. Multicenter, prospective mega trials with a randomized and controlled design are needed to resolve these issues.