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.
Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
H
H
Abe
Y
Y
Iwami
T
T
Nagatomo
Y
Y
Miura
Y
Y
Nakashima
D000328:Adult; D000465:Algorithms; D015716:Electrocardiography, Ambulatory; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D019462:Syncope, Vasovagal / Q000517:prevention & control*