Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study

Background: Undiagnosed sinus or atrioventricular node dysfunction may bias estimation of the real efficacy of cardiac pacing in preventing vasovagal reflex syncope. We assessed this hypothesis in the BIOSync CLS trial which showed that dual-chamber pacing with closed loop stimulation (CLS) remarkab...

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Autores: Russo, Vincenzo, Anguera Camós, Ignasi, Lange, Frederik J. de, Ruvo, Ermenegildo de, Taieb, Jérôme, Zardini, Marco, Nigro, Gerardo, Giacopelli, Daniele, Gargaro, Alessio, Brignole, Michele
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/178787
Acceso en línea:https://hdl.handle.net/2445/178787
Access Level:acceso abierto
Palabra clave:Marcapassos
Síncope (Patologia)
Assaigs clínics
Cardiac pacemakers
Syncope (Pathology)
Clinical trials
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spelling Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS studyRusso, VincenzoAnguera Camós, IgnasiLange, Frederik J. deRuvo, Ermenegildo deTaieb, JérômeZardini, MarcoNigro, GerardoGiacopelli, DanieleGargaro, AlessioBrignole, MicheleMarcapassosSíncope (Patologia)Assaigs clínicsCardiac pacemakersSyncope (Pathology)Clinical trialsBackground: Undiagnosed sinus or atrioventricular node dysfunction may bias estimation of the real efficacy of cardiac pacing in preventing vasovagal reflex syncope. We assessed this hypothesis in the BIOSync CLS trial which showed that dual-chamber pacing with closed loop stimulation (CLS) remarkably reduced recurrences of syncope. Methods and results: In the study patients aged 40 years or older with ≥2 episodes of loss of consciousness in the last year and an asystolic response to Tilt-Table test were randomized to pacing ON (DDD-CLS mode) or pacing OFF (ODO mode). We utilized the available pacemaker diagnostic data in a total of 103 patients (52 pacing ON, 51 pacing OFF) to generate cumulative distribution charts for heart rate (HR) and percentage of pacing. At 12 months, we did not find evidence of suspected sinus or atrioventricular node dysfunction. Beats were similarly distributed between groups (p = 0.96), with an average HR of 76 ± 8 bpm (pacing ON) versus 77 ± 7 bpm (pacing OFF). In the active group, the median percentage of atrial and ventricular pacing was 47% and 0%, respectively. Intolerance to high pacing rates was reported in only one patient (1.6%) and was easily resolved by reprogramming the maximum CLS pacing rate. Conclusions: We did not find evidence of suspected sinus or atrioventricular node dysfunction in the BIOSync CLS patients. The benefit of pacing should be ascribed to pacing prevention of pure vasovagal episodes. CLS algorithm modulated pacing rates over a wide frequency range, consistently competing with sinus node.Elsevier BV2021202120212021info:eu-repo/semantics/article3 p.application/pdfhttps://hdl.handle.net/2445/178787Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1016/j.ijcard.2021.04.032International Journal of Cardiology, 2021, vol. 335, p. 52-54https://doi.org/10.1016/j.ijcard.2021.04.032cc by-nc-nd (c) Russo, Vincenzo et al., 2021http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1787872026-05-29T05:05:01Z
dc.title.none.fl_str_mv Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
title Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
spellingShingle Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
Russo, Vincenzo
Marcapassos
Síncope (Patologia)
Assaigs clínics
Cardiac pacemakers
Syncope (Pathology)
Clinical trials
title_short Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
title_full Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
title_fullStr Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
title_full_unstemmed Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
title_sort Heart rate distribution in paced and non-paced patients with severe recurrent reflex syncope and tilt-induced asystole: Findings from the BIOSync CLS study
dc.creator.none.fl_str_mv Russo, Vincenzo
Anguera Camós, Ignasi
Lange, Frederik J. de
Ruvo, Ermenegildo de
Taieb, Jérôme
Zardini, Marco
Nigro, Gerardo
Giacopelli, Daniele
Gargaro, Alessio
Brignole, Michele
author Russo, Vincenzo
author_facet Russo, Vincenzo
Anguera Camós, Ignasi
Lange, Frederik J. de
Ruvo, Ermenegildo de
Taieb, Jérôme
Zardini, Marco
Nigro, Gerardo
Giacopelli, Daniele
Gargaro, Alessio
Brignole, Michele
author_role author
author2 Anguera Camós, Ignasi
Lange, Frederik J. de
Ruvo, Ermenegildo de
Taieb, Jérôme
Zardini, Marco
Nigro, Gerardo
Giacopelli, Daniele
Gargaro, Alessio
Brignole, Michele
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Marcapassos
Síncope (Patologia)
Assaigs clínics
Cardiac pacemakers
Syncope (Pathology)
Clinical trials
topic Marcapassos
Síncope (Patologia)
Assaigs clínics
Cardiac pacemakers
Syncope (Pathology)
Clinical trials
description Background: Undiagnosed sinus or atrioventricular node dysfunction may bias estimation of the real efficacy of cardiac pacing in preventing vasovagal reflex syncope. We assessed this hypothesis in the BIOSync CLS trial which showed that dual-chamber pacing with closed loop stimulation (CLS) remarkably reduced recurrences of syncope. Methods and results: In the study patients aged 40 years or older with ≥2 episodes of loss of consciousness in the last year and an asystolic response to Tilt-Table test were randomized to pacing ON (DDD-CLS mode) or pacing OFF (ODO mode). We utilized the available pacemaker diagnostic data in a total of 103 patients (52 pacing ON, 51 pacing OFF) to generate cumulative distribution charts for heart rate (HR) and percentage of pacing. At 12 months, we did not find evidence of suspected sinus or atrioventricular node dysfunction. Beats were similarly distributed between groups (p = 0.96), with an average HR of 76 ± 8 bpm (pacing ON) versus 77 ± 7 bpm (pacing OFF). In the active group, the median percentage of atrial and ventricular pacing was 47% and 0%, respectively. Intolerance to high pacing rates was reported in only one patient (1.6%) and was easily resolved by reprogramming the maximum CLS pacing rate. Conclusions: We did not find evidence of suspected sinus or atrioventricular node dysfunction in the BIOSync CLS patients. The benefit of pacing should be ascribed to pacing prevention of pure vasovagal episodes. CLS algorithm modulated pacing rates over a wide frequency range, consistently competing with sinus node.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/178787
url https://hdl.handle.net/2445/178787
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.ijcard.2021.04.032
International Journal of Cardiology, 2021, vol. 335, p. 52-54
https://doi.org/10.1016/j.ijcard.2021.04.032
dc.rights.none.fl_str_mv cc by-nc-nd (c) Russo, Vincenzo et al., 2021
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Russo, Vincenzo et al., 2021
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 3 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier BV
publisher.none.fl_str_mv Elsevier BV
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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