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Natural and Unnatural History of Patients with Severe Carotid Sinus Hypersensitivity: A Preliminary Study
Author(s) -
BRIGNOLE MICHELE,
MENOZZI CARLO,
LOLLI GINO,
SARTORE BRUNO,
BARRA MAURO
Publication year - 1988
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1988.tb06286.x
Subject(s) - medicine , natural history , implant , prospective cohort study , surgery , syncope (phonology) , sinus (botany) , carotid sinus , blood pressure , botany , biology , genus
Natural history of patients with symptomatic severe carotid sinus hypersensitivity is not clearly known. In order to evaluate the effectiveness of pacing therapy in these patients we performed a randomized treatment/no‐treatment prospective study in 35 patients. They were randomly assigned to two groups: 19 patients received no therapy, 16 patients received a VVI (# 11) or DDD (#) pacemaker implant. During the 8.4 ± 4.3 month follow‐up period patients receiving no therapy had recurrence of syncope in 9 cases (47%) and minor symptoms in 13 (68%); at the 16th month, actuarial curve showed absence of syncope in 36% of patients and of any symptoms in 30%. During the 7.2 ±4.1 month follow‐up period, the patients receiving the pacemaker implant had no recurence of syncope, minor symptoms in three (19%); at the 16th month, actuarial curve showed absence of syncope in 100% of patients and of any symptoms in 78%. During follow‐up, 12 patients in no‐treatment group received a pacemaker implant because of the recurrence of severe symptoms; successively they had a strong reduction of symptoms. In conclusion, this study definitively demonstrates that patients with severe symptomatic carotid sinus hypersensitivity had a high rate of recurrence of spontaneous symptoms and that in these patients cardiac pacing is a useful therapy.