ReviewHeart rhythm2020
Pacing in vasovagal syncope: Physiology, pacemaker sensors, and recent clinical trials-Precise patient selection and measurable benefit.
Review in Heart rhythm, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 31 citations in OpenAlex.
- The clinical role of closed loop stimulation pacemakers in the treatment of patients with sinus node dysfunction: a review.Future cardiology · 2025Review
- Cardioneuroablation for the management of patients with recurrent vasovagal syncope and symptomatic bradyarrhythmias: the CNA-FWRD Registry.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Observational
- Advances in diagnosis, management, and long-term outcomes of pediatric vasovagal syncope: a comprehensive review.Frontiers in cardiovascular medicine · 2025Review
- Recent Advances and Future Directions in Syncope Management: A Comprehensive Narrative Review.Journal of clinical medicine · 2024Review
- Cardioneuroablation for the Treatment of Vasovagal Syncope Induced by Chili Pepper Stimulation: A Case Report.International medical case reports journal · 2024Article
- A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Selective cardioneuroablation of the posteromedial left ganglionated plexus for drug-resistant swallow syncope with functional atrioventricular block.HeartRhythm case reports · 2023Article
- Prevalence of asystole during tilt test-induced vasovagal syncope may depend on test methodology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- A novel and practical method to add video monitoring to tilt table testing.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- How to unblur the vasovagal evidence?Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Article
- The benefit of cardioneuroablation to reduce syncope recurrence in vasovagal syncope patients: a case-control study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Cardiac Pacing in Cardioinhibitory Reflex Syncope: Clinical Use of Closed-loop Stimulation.Arrhythmia & electrophysiology review · 2021Review
- Tilt testing remains a valuable asset.European heart journal · 2021Article
- 2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients.Indian pacing and electrophysiology journalArticle
- Why is the Tilt Table Test Still Useful to Define who Should or Should Not Get A Pacemaker with Vasovagal Syncope?Journal of atrial fibrillationArticle
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 4 countries.
Funding
Abstract
The role of pacing in vasovagal syncope (VVS) is considered from a physiological basis. Most VVS patients lose consciousness due to hypotension before severe bradycardia/asystole occurs. Patients who benefit from dual-chamber pacing typically are older with highly symptomatic, late-onset, frequent and severe syncope with short/no prodrome and documented severe cardioinhibition. Tilt testing is of value in patients with recurrent unexplained syncope to identify important hypotensive susceptibility stemming from reduced venous return and stroke volume (SV). A negative tilt test in vasovagal patients with spontaneous asystole documented by an implantable/insertable loop recorder is associated with lower syncope recurrence rates after pacemaker implantation. Pacing may be more effective if triggered by sensor detection of a parameter changing earlier in the reflex than bradycardia when SV may still be relatively preserved. In this regard, detection of right ventricular impedance offers promise. Conservatism is recommended, limiting pacing in VVS to a small subset of symptomatic older patients with clearly documented cardioinhibition and paying particular attention to the timing of loss of consciousness in relation to asystole/bradycardia. Understanding VVS physiology permits application of well-timed, appropriate pacing that yields benefit for highly symptomatic patients.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.