PMID- 33594860
OWN - NLM
STAT- MEDLINE
DCOM- 20210423
LR  - 20210423
IS  - 1678-9741 (Electronic)
IS  - 0102-7638 (Print)
IS  - 0102-7638 (Linking)
VI  - 36
IP  - 1
DP  - 2021 Feb 1
TI  - Syncope in Patients with Cardiac Pacemakers.
PG  - 18-24
LID - 10.21470/1678-9741-2020-0076 [doi]
AB  - INTRODUCTION: It is challenging to diagnose syncope in patients with pacemakers. 
      Because these patients have increased morbidity and mortality risks, they require 
      immediate attention to determine the causes in order to provide appropriate 
      treatment. This study aimed to investigate the causes and predictive factors of 
      syncope as well as the methods used to diagnose syncope in cardiac pacemaker 
      patients. METHODS: Patients with pacemakers implanted owing to sinus node disease 
      or atrioventricular block were evaluated with standardized questionnaires, 
      endocavitary electrograms, and other tests based on the suspected causes of 
      syncope. Mann- Whitney U tests were used to analyze continuous variables and 
      Chi-squared or Fisher's exact tests were used for categorical variables. Logistic 
      regression was used for multivariate analyses. Statistical significance was 
      P<0.05. RESULTS: The study included 95 patients with pacemakers: 47 experienced 
      syncope in the last 12 months and 48 did not. Of the 100 documented episodes of 
      syncope, 48.9% were vasovagal syncopes, 17% had cardiac-related causes, 10.6% had 
      unknown causes, and 8.5% had pacemaker failure. The multivariate analysis showed 
      that a New York Heart Association (NYHA) Functional Class II was a significant 
      factor for developing syncope (P<0.01). CONCLUSION: While the most common type of 
      syncope in pacemaker patients was neurally mediated, it is important to perform 
      detailed evaluations in this population as the causes of syncope can be 
      life-threatening. The best diagnostic methods were stored electrogram analysis 
      and the tilt table test. NYHA Functional Class II patients were found to have a 
      higher risk for syncope.
FAU - Rocha, Eduardo Arrais
AU  - Rocha EA
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil. ORCID: 0000-0001-8975-1182
FAU - Cunha, Gisele Schineider
AU  - Cunha GS
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
FAU - Tavares, Aline Bezerra
AU  - Tavares AB
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
FAU - Viana, Antonio Brazil Junior
AU  - Viana AB Junior
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
FAU - Quidute, Ana Rosa Pinto
AU  - Quidute ARP
AD  - Department of Physiology and Pharmacology, Federal University of Ceara, 
      Fortaleza, Ceara, Brazil.
FAU - Pereira, Francisca Tatiana Moreira
AU  - Pereira FTM
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
FAU - Monteiro, Marcelo de Paula Martins
AU  - Monteiro MPM
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
FAU - Rocha, Maria Eduarda Quidute Arrais
AU  - Rocha MEQA
AD  - University of Fortaleza, Fortaleza, Ceara, Brazil.
FAU - Gomes, Camila Rabelo Ferreira
AU  - Gomes CRF
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
FAU - Rodrigues, Carlos Roberto Martins Sobrinho
AU  - Rodrigues CRM Sobrinho
AD  - Department of Clinical Medicine, Federal University of Ceara, Fortaleza, Ceara, 
      Brazil.
LA  - eng
PT  - Journal Article
DEP - 20210201
PL  - Brazil
TA  - Braz J Cardiovasc Surg
JT  - Brazilian journal of cardiovascular surgery
JID - 101677045
SB  - IM
MH  - *Atrioventricular Block
MH  - Humans
MH  - *Pacemaker, Artificial
MH  - Syncope/diagnosis/etiology
MH  - *Syncope, Vasovagal/diagnosis/etiology/therapy
MH  - Tilt-Table Test
PMC - PMC7918387
OTO - NOTNLM
OT  - Attention
OT  - Cardiac Conduction System Disease
OT  - Pacemaker, Artificial
OT  - Surveys and Questionnaires
OT  - Syncope
COIS- No conflict of interest
EDAT- 2021/02/18 06:00
MHDA- 2021/04/24 06:00
PMCR- 2021/01/01
CRDT- 2021/02/17 08:12
PHST- 2021/02/17 08:12 [entrez]
PHST- 2021/02/18 06:00 [pubmed]
PHST- 2021/04/24 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.21470/1678-9741-2020-0076 [doi]
PST - epublish
SO  - Braz J Cardiovasc Surg. 2021 Feb 1;36(1):18-24. doi: 
      10.21470/1678-9741-2020-0076.