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Cited by 30Cardiac pacing and defibrillation studiesCardiovascular Syncope and Autonomic DisordersCardiac electrophysiology and arrhythmias

Course of symptoms and spontaneous ECG in pacemaker patients: a 5-year follow-up study

LANGENFELD, HEINER, GRIMM, WOLFRAM, MAISCH, BERNHARD, KOGHSIEK, KURT·1988·Pacing and Clinical Electrophysiology
DOI 10.1111/j.1540-8159.1988.tb05986.x
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Abstract

We investigated the course of symptoms and the spontaneous ECG retrospectively in 308 patients who had received a pacemaker because of atrioventricular (AV) block (n = 115), sick sinus syndrome (SSS, n = 107), bradyarrhythmic atrial fibrillation (bradyarrhythmia, n = 51), carotid sinus syndrome (CSS, n = 16), complete bifascicular block associated with 1st degree AV block (n = 13) and with other indications (n = 6). The mean implantation time was 63 months. The clinical state of 93% of all patients improved after pacemaker implantation; their symptoms decreased markedly. Persisting syncopy in some patients with SSS, however, supports a restricted implantation policy. We rarely saw improved AV conduction in patients with AV block (11%). Furthermore, in patients with SSS, atrial fibrillation occurred significantly more often (35%) than in those with AV block (17%; P less than 0.01). Only 3% of patients with SSS developed 2nd and 3rd degree AV block within the observation period. In all patients with initial bifascicular block and additional 1st degree AV block, pacing prevented further syncopal attacks; four of them showed 3rd degree AV block at control, indicating that pacemaker implantation is mandatory in symptomatic patients with bifascicular disease and 1st degree AV block.

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Crossref · 10.1111/j.1540-8159.1988.tb05986.x

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  • Some observational studies suggest that pacing is highly effective in preventing syncope recurrences when AV block is documented.

    “Although formal RCTs of pacing in thirdor second-degree type 2 AV block have not been performed, some observational studies suggest that pacing is highly effective in preventing syncope recurrences when AV block is documented.”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [341]

  • In the absence of correlation between symptoms and ECG, despite adequate pacing, syncope recurs in approximately 15-28% of patients with sinus node disease at 5 years.

    “In the absence of the above situations, despite adequate pacing, syncope recurs in approximately 15-28% of patients at 5 years 339-341 (see Supplementary Data Table 9 ).”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [341]

  • Langenfeld et al. observed a decline in the rate of syncope from 44 to 3.4% over 5-year follow-up in 115 patients paced for AV block; the recurrence rate was 7% in the subgroup with syncope before pacemaker implantation.

    “Langenfeld et al. 341 observed a decline in the rate of syncope from 44 to 3.4% over 5-year follow-up in 115 patients paced for AV block; the recurrence rate was 7% in the subgroup with syncope before pacemaker implantation.”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [341]

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Authors
LANGENFELD, H., GRIMM, W., MAISCH, B., & KOGHSIEK, K.
Affiliations
Universitätsklinikum Würzburg (DE)
Corresponding author
LANGENFELD, HEINER
ORCID
Venue
Pacing and Clinical Electrophysiology
Publisher
Wiley
Published
1988-12
Volume
11
Issue
12
Pages
2198-2206
ISSN
  • 0147-8389 (ISSN-L)
  • 1540-8159
DOI
10.1111/j.1540-8159.1988.tb05986.x
OpenAlex
W1997253874
Cited by
30
References
19
Citations by year
2023: 1 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 8 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 1
FWCI
0.36
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6420 d)
Locations
  • Pacing and Clinical Electrophysiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
pacemaker implantation, atrioventricular block, sick sinus syndrome, carotid sinus syndrome, bifascicular block, first-degree AV block, syncope, atrioventricular conduction, long-term follow-up, symptom course
MeSH terms
Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Dizziness, Dyspnea, Electrocardiography, Female, Follow-Up Studies, Heart Block, Humans, Male, Middle Aged, Pacemaker, Artificial, Syncope, Time Factors

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