Pacing in vasovagal syncope: a physiological paradox?

CThe physiological principles underlying pacemaker treatment in patients with vasovagal syncope (VVS) have never been reviewed. Current knowledge suggests that pacing the right heart is unlikely to correct blood pressure (BP) during a vasovagal reaction. In adults, the reason for this is that stroke volume (SV) is dictated by central blood volume (CBV) contained in the cardiopulmonary vessels within the chest (i.e. left ventricular preload). Preceding posture-triggered VVS, there is a significant fall in CBV and therefore in SV and cardiac output (CO) long before the onset of bradycardia.

Source: Heart Rhythm - September 23, 2019 Category: Cardiology Authors: Jelle SY. de Jong, David L. Jardine, Jacques WM. Lenders, Wouter Wieling Source Type: research