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Evidence summaries

Pacemaker Therapy for Vasovagal Syncope

Treatment with pacemaker appears not to be effective in the prevention of vasovagal syncope Level of evidence: "B"

A multicentre trial 1 randomized 100 patients with recurrent syncope and positive head-up tilt table test to receive a dual chamber pacemaker with pacing (DDD) or a pacemaker with just sensing but no pacing (ODO). In the ODO group, there were 22/52 (42%) cases of recurrent syncope, and in the DDD group there were 16/48 (33%) of recurrent syncope. The relative risk reduction was 30% (95% CI -33% to 63%, p=0.14).

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).

    References

    • Connolly SJ, Sheldon R, Thorpe KE, Roberts RS, Ellenbogen KA, Wilkoff BL, Morillo C, Gent M, VPS II Investigators. Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: Second Vasovagal Pacemaker Study (VPS II): a randomized trial. JAMA 2003 May 7;289(17):2224-9. [PubMed]

Primary/Secondary Keywords