scholarly journals Cardiac Pacing in Cardioinhibitory Reflex Syncope: Clinical Use of Closed-loop Stimulation

2021 ◽  
Vol 10 (4) ◽  
pp. 244-249
Author(s):  
Marco Tomaino ◽  
Vincenzo Russo ◽  
Daniele Giacopelli ◽  
Alessio Gargaro ◽  
Michele Brignole
Keyword(s):  
Closed Loop ◽  
Carotid Sinus ◽  
Clinical Manifestations ◽  
Cardiac Pacing ◽  
Cardiac Monitoring ◽  
The Past ◽  
Reflex Syncope ◽  
Pacing Mode ◽  
New Evidence ◽  
Closed Loop Stimulation

Cardiac pacing has been studied extensively in patients with reflex syncope over the past two decades. The heterogeneity of the forms and clinical manifestations of reflex syncope explain the controversial results of older randomised clinical trials. New evidence from recent trials has changed medical practice, now leading to clear indications for pacing in patients with asystolic syncope documented during carotid sinus massage, implantable cardiac monitoring or tilt testing. Given that recent trials in reflex syncope have been performed using the closed-loop stimulation algorithm, the authors will briefly discuss this pacing mode, review hypotheses about the mechanisms underlying its activation during syncope and provide practical instructions for programming and troubleshooting.

scholarly journals P-131 Closed loop stimulation cardiac pacing results in appropriate exercise recovery patterns

EP Europace ◽  
2003 ◽  
Vol 4 (Supplement_2) ◽  
pp. B97-B97
Author(s):  
L. Cook ◽  
C. Tomczak ◽  
B.S. Krishnan ◽  
R.G. Haennel ◽  
E.F.G. Busse
Keyword(s):  
Closed Loop ◽  
Cardiac Pacing ◽  
Exercise Recovery ◽  
Closed Loop Stimulation

Reflex syncope

ESC CardioMed ◽  
2018 ◽  
pp. 2024-2028
Author(s):  
Jean-Claude Deharo
Keyword(s):  
Carotid Sinus ◽  
Vasovagal Syncope ◽  
Cardiac Pacing ◽  
Tilt Test ◽  
Specific Situation ◽  
Diagnostic Strategy ◽  
Reflex Syncope ◽  
Specific Subgroup ◽  
Recent Developments ◽  
Head Up Tilt Test

Reflex syncope, also called neurally mediated syncope, accounts for 56–73% of the aetiologies of syncope, with a balanced incidence over the various age categories. The most common form is ‘vasovagal syncope’ where the trigger is pain, fever, instrumentation, emotion, or orthostatic stress; ‘situational syncope’ refers to syncope triggered by a specific situation, that is, micturition, defecation, swallowing, cough; and ‘carotid sinus syncope’, which may be triggered by carotid sinus manipulation or diagnosed in patients with syncope and positive carotid sinus massage. The term ‘atypical reflex syncope’ is used to describe reflex syncope occurring without an apparent trigger: the diagnosis is mainly based on history, exclusion of other causes of syncope, and a positive head-up tilt test. Although recent developments have prompted new pathophysiological hypotheses, including the adenosine pathway, the diagnostic strategy for reflex syncope remains mainly based on clinical evaluation and very few ancillary diagnostic tests. The pharmacological armament is still very limited while new perspectives have been opened for specific subgroup of patients. Regarding the very rare patients who are candidates for permanent cardiac pacing, a new pragmatic approach may help their selection and the prediction of the effect of pacing.

scholarly journals Human tularemia in Italy. Is it a re-emerging disease?

2014 ◽  
Vol 143 (10) ◽  
pp. 2161-2169 ◽  
Author(s):  
D. D'ALESSANDRO ◽  
C. NAPOLI ◽  
A. NUSCA ◽  
A. BELLA ◽  
E. FUNARI
Keyword(s):  
Clinical Manifestations ◽  
Emerging Disease ◽  
Control Measures ◽  
Prevention Measures ◽  
Mortality And Morbidity ◽  
The Real ◽  
The Past ◽  
New Evidence ◽  
Discharge Database ◽  
Significant Mortality

SUMMARYTularemia is a contagious infectious disease due to Francisiella tularensis that can cause serious clinical manifestations and significant mortality if untreated. Although the frequency and significance of the disease has diminished over the last decades in Central Europe, over the past few years, there is new evidence suggesting that tularemia has re-emerged worldwide. To know the real epidemiology of the disease is at the root of correct control measures. In order to evaluate whether tularemia is re-emerging in Italy, data on mortality and morbidity (obtained by the National Institute of Statistics; ISTAT), Italian cases described in the scientific literature and data concerning hospitalizations for tularemia (obtained by the National Hospital Discharge Database) were analysed. From 1979 to 2010, ISTAT reported 474 cases and no deaths. The overall number of cases obtained from the literature review was at least 31% higher than that reported by ISTAT. Moreover, the number of cases reported by ISTAT was 3·5 times smaller than hospitalized cases. In Italy tularemia is sporadic, rarely endemic and self-limiting; but, although the trend of reported tularemia does not support the hypothesis of a re-emerging disease, the study demonstrates a wide underreporting of the disease. The real frequency of the disease should be carefully investigated and taken into account in order to implement specific prevention measures.

scholarly journals Evaluation of Cardiac Pacing with Closed Loop Stimulation Function for Improvement of Sleep Apnea Syndrome

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PJ1_048
Author(s):  
Tatsuo Haraki ◽  
Hiroaki Hirase ◽  
Norio Ishikawa ◽  
Kentaro Kitazaki ◽  
Naoto Hanano
Keyword(s):  
Sleep Apnea ◽  
Closed Loop ◽  
Sleep Apnea Syndrome ◽  
Cardiac Pacing ◽  
Apnea Syndrome ◽  
Closed Loop Stimulation
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