| Summary: | Introduction. Carotid sinus syndrome is characterized by a hypersensitive
carotid sinus and syncope. Although we have clear guidelines for the
diagnosis and treatment of carotid sinus syndrome, the efficacy of pacing
therapy with this indication has not been the subject of many studies.
Objective. This study aimed to assess the efficacy and safety of pacing
therapy in the treatment of patients with carotid sinus syndrome and to
determine the factors contributing to symptoms recurrence after pacemaker
implantation. Methods. This study was retrospective and included 32 patients
in whom a pacemaker was implanted due to carotid sinus syndrome at the
Pacemaker Center, Clinical Center of Serbia, between April 2005 and April
2012. Carotid sinus massage and head-up tilt test (HUTT) were performed to
select patients with cardioinhibitory and mixed type carotid sinus syndrome,
who were enrolled to the study. Results. The mean age of patients was
65.6±11.5 years and 20 (62.5%) were men. The mean follow-up period was
4.3±1.9 years. HUTT was performed in 3 (9.4%) patients. Twenty-seven (84.4%)
patients presented with cardioinhibitory and 5 (15.6%) with mixed type of
carotid sinus syndrome. After pacemaker implantation, 22 (68.7%) patients had
no further symptoms, 8 (25.0%) had syncope and 2 (6.3%) presyncope. The mixed
type of the disease (HR 3.1; 95% CI 1.4-5.1; p=0.021) and implantation of
pacemaker in VVI mode (HR 1.8; 95%CI 1.1-3.2; p=0.034) were independent
predictors of symptoms recurrence. There were 3 (9.4%) perioperative surgical
complications. Conclusion. Pacemaker therapy is an effective and safe
treatment for patients with carotid sinus syndrome. As predictors of symptoms
persistence after pacemaker implantation in our population, we identified the
implantation of pacemaker in VVI mode and the mixed type of carotid sinus
syndrome.
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