title: Permanent cardiac pacing in elderly patients with recurrent falls, dizziness and syncope, and a hypersensitive cardioinhibitory reflex.
abstract: The study was designed to assess the outcome of treatment with permanent dual-chamber pacing of elderly patients with falls, dizziness and syncope associated with the demonstration of a hypersensitive cardioinhibitory reflex. Questionnaires were sent to patients (and their general practitioners) who had been referred to a regional pacing centre with recurrent falls, dizziness or syncope diagnosed as likely to be secondary to cardioinhibitory carotid sinus syndrome or predominantly cardioinhibitory vasovagal syndrome. After pacemaker insertion, 84% of patients had no further syncope over a mean follow-up period of 10 (range 1.5 to 30) months. Minor symptoms persisted in only 40% of all patients. Symptoms were unchanged in 22%. It was concluded that permanent dual-chamber pacing is an effective treatment for elderly patients with recurrent falls, dizziness and syncope in whom a hypersensitive cardioinhibitory reflex is found. Good results were obtained in this group with a simple diagnostic work-up.
authors.affiliation: Department of Cardiology, South Cleveland Hospital, Middlesbrough, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Crilley
authors.forename: B
authors.initials: B
authors.lastname: Herd
authors.forename: C S
authors.initials: CS
authors.lastname: Khurana
authors.forename: C A
authors.initials: CA
authors.lastname: Appleby
authors.forename: M A
authors.initials: MA
authors.lastname: de Belder
authors.forename: A
authors.initials: A
authors.lastname: Davies
authors.forename: J A
authors.initials: JA
authors.lastname: Hall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000150:complications / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D002346:Carotid Sinus / Q000503:physiopathology; D004244:Dizziness / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013575:Syncope / Q000209:etiology / Q000628:therapy*; D019462:Syncope, Vasovagal / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome