The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Cardiac pacing for severe childhood neurally mediated syncope with reflex anoxic seizures
Open accessAbstract
OBJECTIVE: To determine whether permanent cardiac pacing could prevent syncope and seizures in children with frequent severe neurally mediated syncope, and if so whether dual chamber pacing was superior to single chamber ventricular pacing. METHODS: Dual chamber pacemakers were implanted into 12 children (eight male, four female) aged 2-14 years (median 2.8 years) with frequent episodes of reflex anoxic seizures and a recorded prolonged asystole during an attack. The pacemaker was programmed to sensing only (ODO), single chamber ventricular pacing with hysteresis (VVI), and dual chamber pacing with rate drop response (DDD) for four month periods, with each patient allocated to one of the six possible sequences of these modes, according to chronological order of pacemaker implantation. The parent and patient were blinded to the pacemaker mode and asked to record all episodes of syncope or presyncope ("near miss" events). The doctor analysing the results was blinded to the patient and pacemaker mode. RESULTS: One patient was withdrawn from the study after the pacemaker was removed because of infection. In the remaining children, both dual chamber and single chamber pacing significantly reduced the number of syncopal episodes compared with sensing only (p = 0.0078 for both). VVI was as effective as DDD for preventing syncope, but DDD was superior to VVI in reducing near miss events (p = 0.016). CONCLUSIONS: Permanent pacing is an effective treatment for children with severe neurally mediated syncope and reflex anoxic seizures. VVI is as effective as DDD in preventing syncope and seizures, but DDD is superior in preventing overall symptoms.
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“These patients were refractory to multiple medications and appeared to benefit from cardiac pacing.”
From 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope (2015) · cites this paper as [142]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“A small, single-blind randomized trial reported that permanent cardiac pacing greatly reduced syncope burden in young children, with frequent syncope associated with documented asystole.142”
From 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope (2015) · cites this paper as [142]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Finally, a small, double-blind study reported that pacing improved symptoms in very young patients with frequent vasovagal syncope.142”
From 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope (2015) · cites this paper as [142]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“even in the presence of VVS with prolonged asystole, pacemakers should be avoided due to the relatively transient and benign nature of the syndrome.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [402]
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Cites
The North American vasovagal pacemaker study (VPS)
Connolly, S., Sheldon, R., Roberts, R., & Gent, M. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00549-x · Cited by 474
BREATHHOLDING SPELLS (CYANOTIC AND PALLID INFANTILE SYNCOPE)
LOMBROSO, C. T., & Lerman, P. (1967) · PEDIATRICS · doi:10.1542/peds.39.4.563 · Cited by 291
Reflex anoxic seizures ('white breath-holding'): nonepileptic vagal attacks.
Stephenson, J. B. P. (1978) · Archives of Disease in Childhood · doi:10.1136/adc.53.3.193 · Cited by 156
Self-citationDual Chamber Pacing Aborts Vasovagal Syncope Induced by Head‐Up 60° Tilt
Fitzpatrick, A. P., THEODORAKIS, G. N., AHMED, R., Williams, T. D. M., & Sutton, R. (1991) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1991.tb04042.x · Cited by 126
Sheldon, R. S., Koshman, M. L., Wilson, W., Kieser, T., & Rose, S. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00891-6 · Cited by 115
Breath-Holding Spells in Childhood
DiMario, F. J. (1992) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1992.02160130127035 · Cited by 111
Benditt, D. G., Sutton, R., GAMMAGE, M. D., Markowitz, T., Gorski, J., NYGAARD, G. A., FETTER, J. G., & THE INTERNATIONAL RATE‐DROP INVESTIGATORS GROUP (1997) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1997.tb03916.x · Cited by 104
Cardiac Pacing for Prevention of Recurrent Vasovagal Syncope
Benditt, D. G., Petersen, M., Lurie, K. G., Grubb, B. P., & Sutton, R. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-3-199502010-00008 · Cited by 103
Electroencephalographic and clinical study of anoxic convulsions in children
Gastaut, H., & Gastaut, Y. (1958) · Electroencephalography and Clinical Neurophysiology · doi:10.1016/0013-4694(58)90062-2 · Cited by 75
Bridge, E. M., Livingston, S., & Tietze, C. (1943) · The Journal of Pediatrics · doi:10.1016/s0022-3476(43)80257-2 · Cited by 75
Research works printed but not linked: 3
- [14]14. Porter CJ, McGoon MD, Espinosa RE, et al. Apparent breath-holding spells associated with life-threatening bradycardia treated by permanent pacing [abstract]. Pediatr Cardiol 1994;15:260.
- [22]22. Benditt DG. Cardiac pacing for the prevention of vasovagal syncope [editorial comment]. J Am Coll Cardiol 1999;33: 21-3.
- [24]24. Samoil D, Grubb BP, Brewster P, et al. Comparison of sin- gle and dual chamber pacing techniques in prevention of upright tilt induced vasovagal syncope. Eur J Cardiac Pacing Electrophysiol 1993;1:36-41.
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Polyakova, E. A., Trofimova, T. A., Soloviov, V. M., Garipov, R., & Galkina, E. V. (2026) · Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук · doi:10.29413/abs.2026-11.2.6
Pacing for Vasovagal Syncope: Real Efficacy or Placebo Effect?
Sheldon, R. S. (2002) · Springer eBooks · doi:10.1007/978-88-470-2103-7_13
Metadata
- Authors
- McLeod, K. A., Wilson, N., Hewitt, J., Norrie, J., & Stephenson, J. B. P.
- Affiliations
- Royal Hospital for Children (GB)
- Corresponding author
- McLeod, K A
- Venue
- Heart
- Publisher
- BMJ
- Published
- 1999-12-01
- Volume
- 82
- Issue
- 6
- Pages
- 721-725
- ISSN
- 1355-6037 (ISSN-L)
- PMC
- PMC1729207
- OpenAlex
- W2058222956
- Semantic Scholar
- 0ad55906e4a56954e5cb386739cc68c64512764c
- Cited by
- 102
- References
- 26
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 5 · 2018: 9 · 2017: 8 · 2016: 6 · 2015: 3 · 2014: 2 · 2013: 6 · 2012: 4
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- neurally mediated syncope, cardiac pacing, DDD pacing, single-chamber ventricular pacing, syncope prevention, near misses, children
- MeSH terms
- Adolescent, Cardiac Pacing, Artificial, Hypoxia, Brain, Child, Child, Preschool, Double-Blind Method, Electrocardiography, Female, Humans, Male, Seizures, Syncope, Vasovagal
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