Treatment of malignant neurocardiogenic vasovagal syncope with a rate drop algorithm in dual chamber cardiac pacing.
A 29-year-old man with malignant vasovagal syncope presented with episodes of abrupt loss of consciousness associated with an aura, totaling more than 10 episodes over 3 months. Holter monitoring showed cardiac arrest with a duration of 15 seconds. Oral propranolol and disopyramide therapy failed to prevent the syncope. A dual chamber pacemaker with a rate drop response algorithm successfully prevented the syncope but not the aura. There may be multifactors involved in the mechanism of this syndrome. The patient has returned to a normal active life. This rate drop algorithm is an effective therapy for the prevention of syncope in malignant vasovagal syncope.
Abe
H
H
Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Iwami
Y
Y
Nagatomo
T
T
Miura
Y
Y
Nakashima
Y
Y
D000328:Adult; D000465:Algorithms; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D019462:Syncope, Vasovagal / Q000517:prevention & control*