Journal Article

Clinical experience of a new rate drop response algorithm in the treatment of vasovagal and carotid sinus syncope

J. B. Johansen, R. S. Bexton, E. H. Simonsen, T. Markowitz and M. K. Erickson

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 2, issue 3, pages 245-250
Published in print July 2000 | ISSN: 1099-5129
Published online July 2000 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1053/eupc.2000.0107
Clinical experience of a new rate drop response algorithm in the treatment of vasovagal and carotid sinus syncope

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Dual chamber pacing has proven beneficial in patients with sudden drops in heart rate as seen in vasovagal syncope and carotid sinus syndrome. Newer algorithms for faster detection of an insidious drop in heart rate and short lasting intervention pacing at a high rate, as in the rate drop response algorithm in the Medtronic Kappa series of pacemakers, might improve the effect of pacing. Two case reports, that demonstrate the use of these rate drop response algorithms, are presented. A 24-year-old woman with recurrent episodes of syncope and repeated tilt-table tests with vasovagal cardioinhibitory outcomes had a Medtronic Kappa 400 pacemaker implanted. Syncope was abolished during repeat tilt-table testing following pacemaker implantation and proper functioning of the rate drop response algorithm. The patient has been free of syncope during follow-up apart from a single episode that occurred due to neglect of vasovagal warning symptoms. A 52-year-old man with coronary artery disease developed recurrent blackouts. Carotid sinus massage resulted in 5·5 s of asystole and presyncope. A Medtronic Kappa 700 pacemaker with a rate drop response algorithm was implanted and the patient became asymptomatic. The rate drop response algorithm is discussed in detail based upon the case reports, and recommendations are given for the use of this algorithm in patients with vasovagal syncope and carotid sinus syndrome.

Keywords: Neurocardiogenic syncope; vasovagal syncope; carotid sinus syncope; dual chamber pacing; pacemaker programming; rate drop response algorithm

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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