Abstract:

Vasovagal syncope (VVS) is a neurocardiogenic syncope. Cardioinhibitory pattern VVS and mixed pattern VVS are complicated with heart rate drop, and may be treated by pacing intervention. The management of two patients with frequent VVS by rate drop response function pacemaker was reported in this paper. Patients experienced intermittent dizziness and palpitation at episode, followed by convulsion and urinary incontinence.There were no specific changes on routine electrocardiogram and 24 h ambulatory electrocardiogram, and tilt table tests were positive in one patient and negative in the other. Patients underwent implantation of dual chamber pacemaker (DDDR) with rate drop response function. There was frequent pacing intervention combating rate drop during follow up after implantation, and the symptoms were improved, with no incidence of syncope. Rate drop response function pacemaker enjoys significant advantages over drug therapy in management of VVS. However, programming and parameters of pacemaker need to be optimized individually and periodically according to clinical findings.

Key words: vasovagal syncope, tilt table test, pacemaker, rate drop response