[Long-term results of pacemaker therapy in hypersensitive carotid sinus syndrome].
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.
Waldecker
B
B
Medizinische Klinik III der Universität, Heidelberg.
Frees
U
U
Brachmann
J
J
Thorspecken
R
R
Kübler
W
W
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
Langzeitergebnisse der Schrittmachertherapie beim Syndrom des hypersensitiven Karotissinus.