Recurrent Syncope in Patients With Reflex Syncope Treated With Dual-Chamber Pacemakers: Short-Term Associated Factors-A Single-Center Retrospective Study.
| Title: | Recurrent Syncope in Patients With Reflex Syncope Treated With Dual-Chamber Pacemakers: Short-Term Associated Factors-A Single-Center Retrospective Study. |
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| Authors: | Vo TD; Pham Ngoc Thach University of Medicine Ho Chi Minh City Vietnam.; Department of Arrhythmology Cho Ray Hospital Ho Chi Minh City Vietnam.; Kieu ND; Department of Arrhythmology Cho Ray Hospital Ho Chi Minh City Vietnam.; Tran LUP; Department of Arrhythmology Cho Ray Hospital Ho Chi Minh City Vietnam.; Tran CD; Department of Arrhythmology Cho Ray Hospital Ho Chi Minh City Vietnam.; Nguyen TT; Department of Arrhythmology Cho Ray Hospital Ho Chi Minh City Vietnam.; Dao TTB; Department of Medicine HUTECH University Ho Chi Minh City Vietnam. |
| Source: | Journal of arrhythmia [J Arrhythm] 2025 Dec 26; Vol. 41 (6), pp. e70257. Date of Electronic Publication: 2025 Dec 26 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wiley Country of Publication: Japan NLM ID: 101263026 Publication Model: eCollection Cited Medium: Print ISSN: 1880-4276 (Print) Linking ISSN: 18804276 NLM ISO Abbreviation: J Arrhythm Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Publication: 2018- : Tokyo : Wiley; Original Publication: Tokyo : Japanese Society of Cardiac Pacing and Electrophysiology |
| Abstract: | Background: Dual-chamber pacemakers equipped with anti-reflex syncope algorithms are an established therapeutic option for preventing recurrent syncope in selected patients with reflex syncope. However, their efficacy in patients under 40 years old and in non-type 2B syncope remains uncertain and clinical predictors of recurrent syncope post-implantation are not well established.; Objective: To identify clinical factors associated with early recurrence of syncope in patients with reflex syncope who received dual-chamber pacemakers with anti-syncope functionality.; Methods: This retrospective cohort study included 117 patients (65% female) with reflex syncope confirmed by a positive tilt-table test. All received dual-chamber pacemakers. The primary endpoint was syncope recurrence within 6 months.; Results: Among 117 paced patients, 15 (12.8%) had recurrent syncope by 6 months. In the reduced Cox model, all three prespecified variables independently predicted recurrence: female sex (HR: 5.386; 95% CI: 1.689-17.175; p = 0.004), systolic blood pressure differential between the end of the passive phase and the syncope onset (HR: 1.036; 95% CI: 1.008-1.064; p = 0.011), number of prior syncope episodes (HR: 2.950; 95% CI: 1.565-5.561; p = 0.001). ROC-based cutoffs supported descriptive separation (e.g., ≥ 2.5 prior episodes; ΔSBP ≥ 87.5 mmHg; asystole ≥ 13.5 s), but continuous coding was used for modeling to avoid information loss.; Conclusion: Within 6 months of dual-chamber pacemaker implantation, recurrent syncope was more likely in female sex, a larger systolic blood pressure differential between the end of the passive phase and syncope onset, and greater pre-implantation syncope burdens.; (© 2025 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.) |
| Competing Interests: | The authors declare no conflicts of interest. |
| References: | Circulation. 2000 Jul 18;102(3):294-9. (PMID: 10899092); Eur Heart J Open. 2025 Jun 11;5(3):oeaf061. (PMID: 40503339); Medicine (Baltimore). 1990 May;69(3):160-75. (PMID: 2189056); J Am Coll Cardiol. 2017 Oct 3;70(14):1720-1728. (PMID: 28958328); Europace. 2024 Aug 3;26(8):. (PMID: 39082698); Can J Cardiol. 2020 Jan;36(1):79-83. (PMID: 31810744); Europace. 2023 Feb 16;25(2):263-269. (PMID: 36796797); Am J Med. 2006 Dec;119(12):1088.e1-7. (PMID: 17145254); J Am Coll Cardiol. 2017 Aug 1;70(5):e39-e110. (PMID: 28286221); Trials. 2017 May 4;18(1):208. (PMID: 28472974); Europace. 2000 Jan;2(1):66-76. (PMID: 11225598); Ann Intern Med. 1990 Jun 1;112(11):850-63. (PMID: 2188544); J Clin Med. 2024 Jan 26;13(3):. (PMID: 38337421); Circulation. 2012 May 29;125(21):2566-71. (PMID: 22565936); J Physiol Sci. 2019 Nov;69(6):851-859. (PMID: 31721084); Eur Heart J. 2018 Jun 1;39(21):e43-e80. (PMID: 29562291); Front Cardiovasc Med. 2024 Sep 03;11:1333684. (PMID: 39290211); Eur Heart J. 2016 May 14;37(19):1493-8. (PMID: 26242712); Scand Cardiovasc J. 2023 Dec;57(1):1-7. (PMID: 36337012); J Appl Physiol (1985). 2001 Dec;91(6):2611-8. (PMID: 11717226); Eur Heart J. 2021 Feb 1;42(5):508-516. (PMID: 33279955); Eur Heart J. 2021 Sep 14;42(35):3427-3520. (PMID: 34455430); Heart. 2013 Nov;99(21):1609-13. (PMID: 23723446); Intern Emerg Med. 2025 Aug;20(5):1437-1443. (PMID: 40624272); Eur Heart J. 2004 Oct;25(19):1741-8. (PMID: 15451153) |
| Contributed Indexing: | Keywords: blood pressure drop; dual‐chamber pacemaker; recurrent syncope; reflex syncope; tilt‐table test |
| Entry Date(s): | Date Created: 20251229 Date Completed: 20251229 Latest Revision: 20251231 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12742363 |
| DOI: | 10.1002/joa3.70257 |
| PMID: | 41458892 |
| Database: | MEDLINE |
Journal Article