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Syncope in Patients with Cardiac Pacemakers
INTRODUCTION: It is challenging to diagnose syncope in patients with pacemakers. Because these patients have increased morbidity and mortality risks, they require immediate attention to determine the causes in order to provide appropriate treatment. This study aimed to investigate the causes and pre...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cirurgia Cardiovascular
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918387/ https://www.ncbi.nlm.nih.gov/pubmed/33594860 http://dx.doi.org/10.21470/1678-9741-2020-0076 |
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author | Rocha, Eduardo Arrais Cunha, Gisele Schineider Tavares, Aline Bezerra Viana Júnior, Antônio Brazil Quidute, Ana Rosa Pinto Pereira, Francisca Tatiana Moreira Monteiro, Marcelo de Paula Martins Rocha, Maria Eduarda Quidute Arrais Gomes, Camila Rabelo Ferreira Rodrigues Sobrinho, Carlos Roberto Martins |
author_facet | Rocha, Eduardo Arrais Cunha, Gisele Schineider Tavares, Aline Bezerra Viana Júnior, Antônio Brazil Quidute, Ana Rosa Pinto Pereira, Francisca Tatiana Moreira Monteiro, Marcelo de Paula Martins Rocha, Maria Eduarda Quidute Arrais Gomes, Camila Rabelo Ferreira Rodrigues Sobrinho, Carlos Roberto Martins |
author_sort | Rocha, Eduardo Arrais |
collection | PubMed |
description | INTRODUCTION: It is challenging to diagnose syncope in patients with pacemakers. Because these patients have increased morbidity and mortality risks, they require immediate attention to determine the causes in order to provide appropriate treatment. This study aimed to investigate the causes and predictive factors of syncope as well as the methods used to diagnose syncope in cardiac pacemaker patients. METHODS: Patients with pacemakers implanted owing to sinus node disease or atrioventricular block were evaluated with standardized questionnaires, endocavitary electrograms, and other tests based on the suspected causes of syncope. Mann-Whitney U tests were used to analyze continuous variables and Chi-squared or Fisher’s exact tests were used for categorical variables. Logistic regression was used for multivariate analyses. Statistical significance was P<0.05. RESULTS: The study included 95 patients with pacemakers: 47 experienced syncope in the last 12 months and 48 did not. Of the 100 documented episodes of syncope, 48.9% were vasovagal syncopes, 17% had cardiac-related causes, 10.6% had unknown causes, and 8.5% had pacemaker failure. The multivariate analysis showed that a New York Heart Association (NYHA) Functional Class II was a significant factor for developing syncope (P<0.01). CONCLUSION: While the most common type of syncope in pacemaker patients was neurally mediated, it is important to perform detailed evaluations in this population as the causes of syncope can be life-threatening. The best diagnostic methods were stored electrogram analysis and the tilt table test. NYHA Functional Class II patients were found to have a higher risk for syncope. |
format | Online Article Text |
id | pubmed-7918387 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
record_format | MEDLINE/PubMed |
spelling | pubmed-79183872021-03-04 Syncope in Patients with Cardiac Pacemakers Rocha, Eduardo Arrais Cunha, Gisele Schineider Tavares, Aline Bezerra Viana Júnior, Antônio Brazil Quidute, Ana Rosa Pinto Pereira, Francisca Tatiana Moreira Monteiro, Marcelo de Paula Martins Rocha, Maria Eduarda Quidute Arrais Gomes, Camila Rabelo Ferreira Rodrigues Sobrinho, Carlos Roberto Martins Braz J Cardiovasc Surg Original Article INTRODUCTION: It is challenging to diagnose syncope in patients with pacemakers. Because these patients have increased morbidity and mortality risks, they require immediate attention to determine the causes in order to provide appropriate treatment. This study aimed to investigate the causes and predictive factors of syncope as well as the methods used to diagnose syncope in cardiac pacemaker patients. METHODS: Patients with pacemakers implanted owing to sinus node disease or atrioventricular block were evaluated with standardized questionnaires, endocavitary electrograms, and other tests based on the suspected causes of syncope. Mann-Whitney U tests were used to analyze continuous variables and Chi-squared or Fisher’s exact tests were used for categorical variables. Logistic regression was used for multivariate analyses. Statistical significance was P<0.05. RESULTS: The study included 95 patients with pacemakers: 47 experienced syncope in the last 12 months and 48 did not. Of the 100 documented episodes of syncope, 48.9% were vasovagal syncopes, 17% had cardiac-related causes, 10.6% had unknown causes, and 8.5% had pacemaker failure. The multivariate analysis showed that a New York Heart Association (NYHA) Functional Class II was a significant factor for developing syncope (P<0.01). CONCLUSION: While the most common type of syncope in pacemaker patients was neurally mediated, it is important to perform detailed evaluations in this population as the causes of syncope can be life-threatening. The best diagnostic methods were stored electrogram analysis and the tilt table test. NYHA Functional Class II patients were found to have a higher risk for syncope. Sociedade Brasileira de Cirurgia Cardiovascular 2021 /pmc/articles/PMC7918387/ /pubmed/33594860 http://dx.doi.org/10.21470/1678-9741-2020-0076 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Rocha, Eduardo Arrais Cunha, Gisele Schineider Tavares, Aline Bezerra Viana Júnior, Antônio Brazil Quidute, Ana Rosa Pinto Pereira, Francisca Tatiana Moreira Monteiro, Marcelo de Paula Martins Rocha, Maria Eduarda Quidute Arrais Gomes, Camila Rabelo Ferreira Rodrigues Sobrinho, Carlos Roberto Martins Syncope in Patients with Cardiac Pacemakers |
title | Syncope in Patients with Cardiac Pacemakers |
title_full | Syncope in Patients with Cardiac Pacemakers |
title_fullStr | Syncope in Patients with Cardiac Pacemakers |
title_full_unstemmed | Syncope in Patients with Cardiac Pacemakers |
title_short | Syncope in Patients with Cardiac Pacemakers |
title_sort | syncope in patients with cardiac pacemakers |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918387/ https://www.ncbi.nlm.nih.gov/pubmed/33594860 http://dx.doi.org/10.21470/1678-9741-2020-0076 |
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