Pacing in vasovagal syncope: Physiology, pacemaker sensors, and recent clinical trials —Precise patient selection and measurable benefit

Asystole (a lack of ventricular complexes for a period of>3 seconds) occurs in vasovagal syncope (VVS), known as severe cardioinhibition.1 It usually follows hypotension and may even occur after loss of consciousness (LOC).2 It is tempting for the electrophysiologist, having seen asystole on tilt or implantable loop recorder (ILR) in association with syncope, to offer permanent pacing to combat bradycardia/asystole. This approach fails to address the physiology of the vasovagal reflex, in particular the relationship between timing of asystole and LOC and, furthermore, the details of how pacing is triggered by sensing of physiological events.

Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Richard Sutton, Jelle S.Y. de Jong, Julian M. Stewart, Artur Fedorowski, Frederik J. de Lange Tags: Contemporary Review Source Type: research