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'''For patient information on this page, click [[Neurocardiogenic syncope (patient information)|here]]'''
{{Neurocardiogenic syncope}}
{{Neurocardiogenic syncope}}
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{{CMG}}


==ACC / AHA Guidelines- Permanent Pacing in Hypersensitive Carotid Sinus Syndrome and Neurocardiogenic Syncope (DO NOT EDIT) <ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>==
==[[Neurocardiogenic syncope overview|Overview]]==
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===Class I===
==[[Neurocardiogenic syncope pathophysiology|Pathophysiology]]==
1. Permanent [[pacemaker|pacing]] is indicated for recurrent [[syncope]] caused by spontaneously occurring [[carotid sinus]] stimulation and [[carotid sinus]] pressure that induces [[ventricular asystole]] of more than 3 seconds. ''(Level of Evidence: C)''
 
==[[Neurocardiogenic syncope epidemiology and demographics|Epidemiology & Demographics]]==
 
==[[Neurocardiogenic syncope risk factors|Risk Factors]]==


===Class IIa===
==[[Neurocardiogenic syncope causes|Causes]]==
1. Permanent [[pacemaker|pacing]] is reasonable for [[syncope]] without clear, provocative events and with a hypersensitive cardioinhibitory response of 3 seconds or longer. ''(Level of Evidence: C)''


===Class IIb===
==[[Neurocardiogenic syncope natural history|Natural History, Prognosis & Complication]]==
1. Permanent [[pacemaker|pacing]] may be considered for significantly symptomatic neurocardiogenic [[syncope]] associated with [[bradycardia]] documented spontaneously or at the time of tilt-table testing. ''(Level of Evidence: B)''


===Class III===
==[[Neurocardiogenic syncope differentiating from other diseases|Differentiating Neurocardiogenic Syncope From Other Diseases]]==
1. Permanent [[pacemaker|pacing]] is not indicated for a hypersensitive cardioinhibitory response to [[carotid sinus]] stimulation without symptoms or with vague symptoms. ''(Level of Evidence: C)''


2. Permanent [[pacemaker|pacing]] is not indicated for situational vasovagal [[syncope]] in which avoidance behavior is effective and preferred. ''(Level of Evidence: C)''}}
==Diagnosis==
[[Neurocardiogenic syncope symptoms|History & Symptoms]] | [[Neurocardiogenic syncope physical examination|Physical Examination]] | [[Neurocardiogenic syncope electrocardiogram|Electrocardiogram]] | [[Neurocardiogenic syncope chest x-ray|Chest X-Ray]] | [[Neurocardiogenic syncope tilt table testing|Tilt table test]] | [[Neurocardiogenic syncope echocardiography|Echocardiography]] | [[Neurocardiogenic syncope cardiac catheterization|Cardiac Catheterization]]


==Sources==
==Treatment==
* The ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities <ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>
====[[Neurocardiogenic syncope medical treatment|Medical Therapy]]====


==References==
====[[Neurocardiogenic syncope pacemaker therapy|Pacemaker Therapy]]====
{{reflist|2}}
# Neurocardiogenic syncope. Carol Chen-Scarabelli, Tiziano M Scarabelli. BMJ 2004;329:336–41
# Brignole M, Alboni P, Benditt D, Bergfeldt L, Blanc JJ, Bloch Thomsen PE, et al for the Task Force on Syncope, European Society of Cardiology.Guidelines on management (diagnosis and treatment) of syncope. Eur Heart J 2001;22:1256-306.
# Vasovagal Syncope. Alexis M. Fenton, MD; Stephen C. Hammill, MD; Robert F. Rea, MD; Phillip A. Low, MD; and Win-Kuang Shen, MD. Ann Intern Med. 2000;133:714-725.
# Connolly SJ, Sheldon R, Thorpe KE, et al. Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: Second Vasovagal Pacemaker Study (VPS II): a randomized trial. JAMA. 2003;289:2224-9.


{{SIB}}
==Related Chapters==
*[[Vasovagal syncope]]
*[[Postural orthostatic tachycardia syndrome]]
*[[Dysautonomia]]


[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]


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Latest revision as of 17:51, 20 July 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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