Causes of syncopal recurrences in patients treated with permanent pacing for bradyarrhythmic syncope : Findings from the SYNCOPACED registry
Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Few studies have examined the causes of syncope/collapse recurrences in patients with a previously implanted pacemaker for bradyarrhythmic syncope.
OBJECTIVE: The purpose of this study was to assess the causes of syncope/collapse recurrences after pacemaker implantation for bradyarrhythmic syncope in a large patient population.
METHODS: The SYNCOpal recurrences in patients treated with permanent PACing for bradyarrhythmic syncope (SYNCOPACED) registry was a prospective multicenter observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for bradyarrhythmic syncope. During follow-up, the time to the first syncope/collapse recurrence was recorded. Patients with syncope/collapse recurrences underwent a predefined diagnostic workup aimed at establishing the mechanism of syncope/collapse.
RESULTS: During a median follow-up of 50 months, 213 patients (15.6%) reported at least 1 syncope/collapse recurrence. The risk of syncope/collapse recurrence was highest in patients who underwent implantation for cardioinhibitory vasovagal syncope (26.4%), followed by unexplained syncope and chronic bifascicular block (21.5%), cardioinhibitory carotid sinus syndrome (17.2%), atrial fibrillation needing pacing (15.5%), atrioventricular block (13.6%), and sinus node disease (12.5%) (P = .017). The most frequent cause of syncope/collapse recurrence was reflex syncope (27.7%), followed by orthostatic hypotension (26.3%), pacemaker or lead malfunction (5.6%), structural cardiac disease (5.2%), and atrial and ventricular tachyarrhythmias (4.7% and 3.8%, respectively). In 26.8% of cases, the mechanism of syncope/collapse remained unexplained.
CONCLUSION: In patients receiving a pacemaker for bradyarrhythmic syncope, reflex syncope and orthostatic hypotension are the most frequent mechanisms of syncope/collapse recurrence after implantation. Pacing system malfunction, structural cardiac diseases, and tachyarrhythmias are rare mechanisms. The mechanism remains unexplained in >25% of patients.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2021 |
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Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
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Enthalten in: |
Heart rhythm - 18(2021), 5 vom: 15. Mai, Seite 770-777 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Palmisano, Pietro [VerfasserIn] |
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Links: |
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Themen: |
Bradyarrhythmia |
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Anmerkungen: |
Date Completed 18.01.2022 Date Revised 18.01.2022 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1016/j.hrthm.2021.01.010 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM320279391 |
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100 | 1 | |a Palmisano, Pietro |e verfasserin |4 aut | |
245 | 1 | 0 | |a Causes of syncopal recurrences in patients treated with permanent pacing for bradyarrhythmic syncope |b Findings from the SYNCOPACED registry |
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500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
520 | |a BACKGROUND: Few studies have examined the causes of syncope/collapse recurrences in patients with a previously implanted pacemaker for bradyarrhythmic syncope | ||
520 | |a OBJECTIVE: The purpose of this study was to assess the causes of syncope/collapse recurrences after pacemaker implantation for bradyarrhythmic syncope in a large patient population | ||
520 | |a METHODS: The SYNCOpal recurrences in patients treated with permanent PACing for bradyarrhythmic syncope (SYNCOPACED) registry was a prospective multicenter observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for bradyarrhythmic syncope. During follow-up, the time to the first syncope/collapse recurrence was recorded. Patients with syncope/collapse recurrences underwent a predefined diagnostic workup aimed at establishing the mechanism of syncope/collapse | ||
520 | |a RESULTS: During a median follow-up of 50 months, 213 patients (15.6%) reported at least 1 syncope/collapse recurrence. The risk of syncope/collapse recurrence was highest in patients who underwent implantation for cardioinhibitory vasovagal syncope (26.4%), followed by unexplained syncope and chronic bifascicular block (21.5%), cardioinhibitory carotid sinus syndrome (17.2%), atrial fibrillation needing pacing (15.5%), atrioventricular block (13.6%), and sinus node disease (12.5%) (P = .017). The most frequent cause of syncope/collapse recurrence was reflex syncope (27.7%), followed by orthostatic hypotension (26.3%), pacemaker or lead malfunction (5.6%), structural cardiac disease (5.2%), and atrial and ventricular tachyarrhythmias (4.7% and 3.8%, respectively). In 26.8% of cases, the mechanism of syncope/collapse remained unexplained | ||
520 | |a CONCLUSION: In patients receiving a pacemaker for bradyarrhythmic syncope, reflex syncope and orthostatic hypotension are the most frequent mechanisms of syncope/collapse recurrence after implantation. Pacing system malfunction, structural cardiac diseases, and tachyarrhythmias are rare mechanisms. The mechanism remains unexplained in >25% of patients | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Multicenter Study | |
650 | 4 | |a Observational Study | |
650 | 4 | |a Bradyarrhythmia | |
650 | 4 | |a Causes of syncope | |
650 | 4 | |a Pacemaker | |
650 | 4 | |a Syncopal recurrence | |
650 | 4 | |a Syncope | |
650 | 4 | |a Treatment of syncope | |
700 | 1 | |a Dell'Era, Gabriele |e verfasserin |4 aut | |
700 | 1 | |a Pellegrino, Pier Luigi |e verfasserin |4 aut | |
700 | 1 | |a Ammendola, Ernesto |e verfasserin |4 aut | |
700 | 1 | |a Ziacchi, Matteo |e verfasserin |4 aut | |
700 | 1 | |a Guerra, Federico |e verfasserin |4 aut | |
700 | 1 | |a Aspromonte, Vittorio |e verfasserin |4 aut | |
700 | 1 | |a Laffi, Mattia |e verfasserin |4 aut | |
700 | 1 | |a Pimpini, Lorenzo |e verfasserin |4 aut | |
700 | 1 | |a Santoro, Francesco |e verfasserin |4 aut | |
700 | 1 | |a Boggio, Enrico |e verfasserin |4 aut | |
700 | 1 | |a Guido, Alessandro |e verfasserin |4 aut | |
700 | 1 | |a Patti, Giuseppe |e verfasserin |4 aut | |
700 | 1 | |a Brunetti, Natale Daniele |e verfasserin |4 aut | |
700 | 1 | |a Nigro, Gerardo |e verfasserin |4 aut | |
700 | 1 | |a Biffi, Mauro |e verfasserin |4 aut | |
700 | 1 | |a Russo, Antonio Dello |e verfasserin |4 aut | |
700 | 1 | |a Gaggioli, Germano |e verfasserin |4 aut | |
700 | 1 | |a Accogli, Michele |e verfasserin |4 aut | |
700 | 0 | |a of the Italian Association of Arrhythmology and Cardiac Pacing |e verfasserin |4 aut | |
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