The role of cardiac pacing therapy in the management of carotid sinus syndrome
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....
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2015-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2015/0370-81791502023R.pdf |
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| author | Radovanović Nikola Kirćanski Bratislav Pavlović Siniša Raspopović Srđan Jovanović Velibor Milašinović Goran |
| author_facet | Radovanović Nikola Kirćanski Bratislav Pavlović Siniša Raspopović Srđan Jovanović Velibor Milašinović Goran |
| author_sort | Radovanović Nikola |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T13:47:42Z |
| format | Article |
| id | doaj.art-5d4309552cb14cd68445772143b9efc7 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-13T13:47:42Z |
| publishDate | 2015-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-5d4309552cb14cd68445772143b9efc72022-12-21T23:43:21ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792015-01-011431-2232710.2298/SARH1502023R0370-81791502023RThe role of cardiac pacing therapy in the management of carotid sinus syndromeRadovanović Nikola0Kirćanski Bratislav1Pavlović Siniša2Raspopović Srđan3Jovanović Velibor4Milašinović Goran5Clinical Center of Serbia, Pacemaker Center, BelgradeClinical Center of Serbia, Pacemaker Center, BelgradeClinical Center of Serbia, Pacemaker Center, Belgrade + School of Medicine, BelgradeClinical Center of Serbia, Pacemaker Center, BelgradeClinical Center of Serbia, Pacemaker Center, BelgradeClinical Center of Serbia, Pacemaker Center, Belgrade + School of Medicine, BelgradeIntroduction. 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.http://www.doiserbia.nb.rs/img/doi/0370-8179/2015/0370-81791502023R.pdfsyncopecarotid sinus syndromepacemaker therapy |
| spellingShingle | Radovanović Nikola Kirćanski Bratislav Pavlović Siniša Raspopović Srđan Jovanović Velibor Milašinović Goran The role of cardiac pacing therapy in the management of carotid sinus syndrome Srpski Arhiv za Celokupno Lekarstvo syncope carotid sinus syndrome pacemaker therapy |
| title | The role of cardiac pacing therapy in the management of carotid sinus syndrome |
| title_full | The role of cardiac pacing therapy in the management of carotid sinus syndrome |
| title_fullStr | The role of cardiac pacing therapy in the management of carotid sinus syndrome |
| title_full_unstemmed | The role of cardiac pacing therapy in the management of carotid sinus syndrome |
| title_short | The role of cardiac pacing therapy in the management of carotid sinus syndrome |
| title_sort | role of cardiac pacing therapy in the management of carotid sinus syndrome |
| topic | syncope carotid sinus syndrome pacemaker therapy |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2015/0370-81791502023R.pdf |
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