open access

Vol 12, No 5 (2017)
Case Reports
Published online: 2017-11-22
Get Citation

18 - second pause during a tilt test - what next?

Irmina Urbanek, Izabela Poddębska, Paweł Ptaszyński
DOI: 10.5603/FC.2017.0090
·
Folia Cardiologica 2017;12(5):479-483.

open access

Vol 12, No 5 (2017)
Case Reports
Published online: 2017-11-22

Abstract

Authors present a case report of a young man with whom despite to the fainting and significant pauses during a tilt test, implantation of pacemaker was not performed. The patient remains in outpatients care and he seems to refer advantage of the conservative treatment. Above procedure, there is in accordance with current guidelines, which emphasize the selection of a small group of patients among which invasive treatment (pacemaker implantation) should be considered. Recent studies point out an increasing role of prolonged Holter monitoring and implantable events recorders. In contrast, there is no evidence that cardiodepressive syncope during tilt test indicates pacemaker implantation as first-line therapy.

Abstract

Authors present a case report of a young man with whom despite to the fainting and significant pauses during a tilt test, implantation of pacemaker was not performed. The patient remains in outpatients care and he seems to refer advantage of the conservative treatment. Above procedure, there is in accordance with current guidelines, which emphasize the selection of a small group of patients among which invasive treatment (pacemaker implantation) should be considered. Recent studies point out an increasing role of prolonged Holter monitoring and implantable events recorders. In contrast, there is no evidence that cardiodepressive syncope during tilt test indicates pacemaker implantation as first-line therapy.
Get Citation

Keywords

syncope, tilt test, pause, pacemaker

About this article
Title

18 - second pause during a tilt test - what next?

Journal

Folia Cardiologica

Issue

Vol 12, No 5 (2017)

Pages

479-483

Published online

2017-11-22

DOI

10.5603/FC.2017.0090

Bibliographic record

Folia Cardiologica 2017;12(5):479-483.

Keywords

syncope
tilt test
pause
pacemaker

Authors

Irmina Urbanek
Izabela Poddębska
Paweł Ptaszyński

References (8)
  1. Brignole M, Auricchio A, Baron-Esquivias G, et al. European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA). 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace. 2013; 15(8): 1070–1118.
  2. Moya A, Sutton R, Ammirati F, et al. Task Force for the Diagnosis and Management of Syncope, European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), Heart Rhythm Society (HRS). Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J. 2009; 30(21): 2631–2671.
  3. Brignole M, Sutton R, Menozzi C, et al. International Study on Syncope of Uncertain Etiology 2 (ISSUE 2) Group. Lack of correlation between the responses to tilt testing and adenosine triphosphate test and the mechanism of spontaneous neurally mediated syncope. Eur Heart J. 2006; 27(18): 2232–2239.
  4. Brignole M, Menozzi C, Moya A, et al. International Study on Syncope of Uncertain Etiology 3 (ISSUE-3) Investigators. Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial. Circulation. 2012; 125(21): 2566–2571.
  5. Brignole M, Donateo P, Tomaino M, et al. International Study on Syncope of Uncertain Etiology 3 (ISSUE-3) Investigators. Benefit of pacemaker therapy in patients with presumed neurally mediated syncope and documented asystole is greater when tilt test is negative: an analysis from the third International Study on Syncope of Uncertain Etiology (ISSUE-3). Circ Arrhythm Electrophysiol. 2014; 7(1): 10–16.
  6. Soteriades ES, Evans JC, Larson MG, et al. Incidence and prognosis of syncope. N Engl J Med. 2002; 347(12): 878–885.
  7. Krediet CT, Parry SW, Jardine DL, et al. The history of diagnosing carotid sinus hypersensitivity: why are the current criteria too sensitive? Europace. 2011; 13(1): 14–22.
  8. Sheldon RS, Grubb BP, Olshansky B, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015; 12(6): e41–e63.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl