Permanent pacemaker implantation in unexplained syncope patients with electrophysiology study-proven atrioventricular node disease

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction: Syncope, whose cause is unknown after an initial assessment, has an uncertain prognosis. It is critical to identify patients at highest risk who may require a pacemaker and to identify the cause of recurrent syncope to prescribe proper therapy Purpose Aim of this study was to evaluate the effect of permanent pacing on the incidence of syncope in patients with unexplained syncope and electrophysiology study-proven atrioventricular node disease. Methods This was an observational study based on a prospective registry of 236 consecutive patients (60.20 ± 18.66 years, 63.1% male, 60.04 ± 9.50 bpm) presenting with recurrent unexplained syncope attacks admitted to our hospital for invasive electrophysiology study (EPS). Τhe implantation of a permanent antibradycardia pacemaker (ABP) was offered to all patients according to the results of the EPS. 135 patients received the ABP, while 101 denied. Results The mean of reported syncope episodes was 1.97 ± 1.10 (or presyncope 2.17 ± 1.50) before they were referred for a combined EP guided diagnostic and therapeutic approach. Over a mean follow-up of approximately 4 years (49.19 ± 29.58 months), the primary outcome event (syncope) occurred in 31 of 236 patients (13.1%), 6 of 135 (4.4%) in the ABP group as compared to 25 of 101 (24.8%) in the no pacemaker group (p < 0.001). Conclusion Among patients with a history of unexplained syncope, a set of positivity criteria for the presence of EPS defined atrioventricular node disease, identifies a subset of patients who will benefit from permanent pacing.

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Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184906 ◽

2018 ◽

Vol 6 (12) ◽

pp. 4053

Author(s):

Sanjeev Bhat ◽

Dharminder Kumar ◽

Aditi Parimoo

Keyword(s):

Sinus Node ◽

Pacemaker Implantation ◽

Permanent Pacemaker ◽

Single Chamber ◽

Common Indication ◽

Permanent Pacemaker Implantation ◽

Pacing Mode ◽

Node Disease ◽

Sinus Node Disease ◽

Pacemaker Insertion

Background: To determine the demographic details, indications, type of pacemakers and complications in patients undergoing the permanent pacemaker implantation.Methods: This was a single-center, retrospective study conducted in at a tertiary-care center in India. The records of 200 patients who had undergone implantation of permanent pacemakers in the period of May 2016 to April 2018 were reviewed.Results: Total 200 patients with mean age of 67 years were paced. Of these 120 (60%) were males. The mean duration of hospital stay was 6.5 days. Sinus node disease (105 patients, 52.5%) was the most common indication for permanent pacemaker insertion. Single chamber (VVIR) pacing mode (125 patients, 62.5%) was found to be the most common pacing mode used for pacemaker insertion. Among the 200 patients complications were observed in 8 patients (4%). Of these 8 patients, pneumothorax (4 patients, 2%) was found to be the most common complication for permanent pacemaker implantation followed by local site infection (1 patient, 0.5%). Only 1 patient (0.5%) died during the observation period of the study.Conclusions: Geriatric population with male predominance have observed to commonly undergo permanent pacemaker implantation. Sinus node disease in the elderly patients is the most common indication for cardiac pacing followed by atrioventricular block. Single chamber (VVIR) pacing mode is commonly used followed by dual chamber (DDDR) due to economic reasons in India. Pacemaker implantation is a relatively safe procedure with a low complication rate.

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