Premium
Reproducibility of tilt‐table test result in patients with malignant neurocardiogenic syncope
Author(s) -
Omar A. R.,
Ng K.S.,
Ng W.L.,
Sutandar A.
Publication year - 2004
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1444-0903.2004.00626.x
Subject(s) - medicine , syncope (phonology) , vasovagal syncope , asystole , tilt table test , cardiology , implantable loop recorder , anesthesia , sick sinus syndrome , heart rate , blood pressure , atrial fibrillation
The indication for permanent pacemaker remains controversial in malignant neurocardiogenic syncope. A highly reproducible prolonged pause during a repeat head‐up tilt‐table testing may identify a subgroup of neurally mediated syncope with a prominent and consistent cardioinhibitory component. Seven patients (3 females) with a mean age of 30 years (23−44 years) were diagnosed to have malignant neurocardiogenic syncope; all are classified according to the Vasovagal Syncope International Study as 2B type, with observed sinus pauses ranged from 3 s to 26 s of which only 1 demonstrated a reproducible sinus pause. No recurrence of syncope was clinically observed in patients during the follow‐up period. Of 6 patients treated non‐pharmacologically, one required a beta‐blocker and none required a permanent pacemaker. Prolonged asystole manifest during head‐up tilt‐table testing is a poorly reproducible phenomenon and permanent pacemaker implantation in malignant neurocardiogenic syncope should not be a first line therapy. (Intern Med J 2004; 34: 504−506)