[Comparison of permanent cardiac pacing and cardiac pacing on demand in mixed carotid sinus syndrome. Acute- and medium-term follow-up study].
The aim of the study was to evaluate the importance of atrial synchronism for pacing therapy of patients with mixed carotid sinus syndrome. On 23 patients (21 m, 2 f; mean age 69 +/- 8 years) affected by symptomatic mixed carotid sinus syndrome we performed: 1) the study of ventriculo-atrial conduction, 2) the evaluation of pacemaker effect and 3) the carotid sinus massage in standing position during VVI and DVI temporary pacing. All patients received a permanent DVI pacemaker and then underwent a two-month period single-blind, randomized, cross-over study on DVI vs VVI mode. During DVI period, no syncope occurred in any patients, minor symptoms persisted in 11 (48%) of them; during VVI period syncopes recurred in 3 patients, symptoms requiring the withdrawal of VVI pacing and premature DVI reprogramming in 8, minor symptoms were observed in 17 (74%). A comparison between 14 patients who preferred DVI period (Group A) and the remaining 9 patients who had no preference for DVI and VVI period (Group B) revealed that Group A patients had a greater pacemaker effect (-34 +/- 16 mmHg vs -16 +/- 14 mmHg; p less than 0.02) and a higher prevalence of ventriculo-atrial conduction (78% vs 44%; p = 0.1), while the entity of the systolic pressure fall caused by carotid sinus massage was similar in the two groups both during VVI mode (Group A -51 +/- 16 mmHg vs Group B -56 +/- 27 mmHg) and DVI mode (Group A -38 +/- 17 mmHg vs Group B -45 +/- 17 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)
Brignole
M
M
Laboratorio di Elettrofisiologia ed Impianto di Pacemakers, Servizio di Cardiologia, Ospedali Riuniti di Lavagna GE.
Barra
M
M
Sartore
B
B
Menozzi
C
C
Lolli
G
G
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002340:Carotid Artery Diseases / Q000503:physiopathology* / Q000628:therapy; D002346:Carotid Sinus; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008405:Massage; D008875:Middle Aged; D013575:Syncope / Q000628:therapy*; D013577:Syndrome
Confronto tra stimolazione DVI e VVI nella sindrome del seno carotideo mista. Uno studio in acuto e a medio termine.