Permanent Cardiac Pacing Versus Medical Treatment for the Prevention of Recurrent Vasovagal Syncope
Why the study?
Does permanent dual-chamber cardiac pacing reduce the recurrence of syncope in patients with recurrent vasovagal syncope compared to atenolol?
Population
93 patients with recurrent vasovagal syncope, mean age 58.1 years, 38 men and 55 women.
Comparison
Permanent dual-chamber cardiac pacemaker… vs Beta-blocker atenolol at a dosage of 100 mg once…
Design
RCT, Randomized (method not specified in abstract)
Follow-up
Median 390 days and 135 days
Authors
Discussion
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Member takes
Implication
Supports pacing over atenolol to prevent syncope recurrence in recurrent vasovagal syncope; confirms rate-drop response efficacy in highly symptomatic patients.
Structured PICO
Does permanent dual-chamber cardiac pacing reduce the recurrence of syncope in patients with recurrent vasovagal syncope compared to atenolol?
P
Population
93 patients with recurrent vasovagal syncope (age >35 years, ≥3 syncopal spells in the preceding 2 years, and positive response to tilt table testing with syncope occurring in association with relative bradycardia), mean age 58.1 years, 38 men and 55 women.
I
Intervention
Permanent dual-chamber (DDD) cardiac pacemaker provided with rate-drop response function.
C
Comparator
Beta-blocker atenolol at a dosage of 100 mg once a day.
O
Outcome
First recurrence of syncope after randomization.hard clinical
Permanent DDD pacing with rate-drop response function is significantly more effective than atenolol for preventing syncope recurrence in highly symptomatic patients with vasovagal syncope and relative bradycardia.
Limitations
- Early termination of the trial due to interim analysis results
Cite This Study
Ammirati et al. (2001) studied this question.