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Lookup NU author(s): Dr Rodney Bexton
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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 crop 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. (Europace 2000; 2: 245-250) (C) 2000 The European Society of Cardiology.
Author(s): Johansen JB, Bexton RS, Simonsen EH, Markowitz T, Erickson MK
Publication type: Article
Publication status: Published
Journal: Europace
Year: 2000
Volume: 2
Issue: 3
Pages: 245-250
ISSN (print): 1099-5129
ISSN (electronic): 1532-2092
Publisher: Oxford University Press
URL: http://dx.doi.org/10.1053/eupc.2000.0107
DOI: 10.1053/eupc.2000.0107
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