title: [Long-term results of pacemaker therapy in hypersensitive carotid sinus syndrome].
abstract: 131 patients received permanent pacemakers to treat their hypersensitive carotis sinus syndrome (HCSS). Prior to implantation, HCSS was diagnosed whenever spontaneous episodes of faintness or dizziness (n = 25) or syncope (n = 106) coincided with an abnormal response to carotis sinus massage (asystole greater than 3 s). 123 patients were followed for 48 +/- 27 months after implantation to assess the value of pacemaker therapy. 77% of all patients were free of initial symptoms. 90% of patients with syncope prior to pacemaker therapy were free of recurrence. Therefore, permanent pacing appears to be the treatment of choice for these patients. Since carotis sinus massage produced high-degree AV-block in at least 33% of patients, ventricular (rather than exclusive atrial) pacing seems to be mandatory. However, syncope did recur in 10% despite normal pacemaker function. The etiology of these recurrences remained unclear in almost all patients. As opposed to patients with syncope, cardiac pacing prevented symptoms in only 26% of patients with faintness or dizziness without full syncope. In these patients primary and sole pacemaker therapy does not appear to be appropriate.
authors.affiliation: Medizinische Klinik III der Universität, Heidelberg.
authors.forename: B
authors.initials: B
authors.lastname: Waldecker
authors.forename: U
authors.initials: U
authors.lastname: Frees
authors.forename: J
authors.initials: J
authors.lastname: Brachmann
authors.forename: R
authors.initials: R
authors.lastname: Thorspecken
authors.forename: W
authors.initials: W
authors.lastname: Kübler
mesh_terms: D000368:Aged; D001919:Bradycardia / Q000628:therapy; D002346:Carotid Sinus / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000628:therapy; D006327:Heart Block / Q000628:therapy*; D006336:Heart Massage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013575:Syncope / Q000517:prevention & control; D013577:Syndrome
vernacular_title: Langzeitergebnisse der Schrittmachertherapie beim Syndrom des hypersensitiven Karotissinus.