LONG-TERM EFFECT OF PACEMAKER THERAPY IN CAROTID-SINUS SYNDROME

Between 1981 and 1990, we prospectively tested the optimal pacing mode for carotid sinus syndrome before pacemaker implantation by performin g carotid sinus pressure during temporary pacing (VVI- and DVI-mode) a nd invasive blood pressure monitoring. In a group of 61 patients with carotid sinus syndrome (37 males, 24 females, mean age: 74 years), art erial blood pressure was sufficiently maintained during VVI-pacing in 28, 33 patients needed dual-chamber pacing. During follow-up (mean: 61 .5 months), 75% of the patients were symptom-free, 8% reported symptom s of minor intensity. Taking into consideration that in further 10% of the patients persisting symptoms after pacemaker implantation might h ave also been caused by other diseases like stenosis of the A. carotis , pacemaker therapy of carotid sinus syndrome failed in only 7% of the patients. Thus, the quantification of the effects of different pacing modes on arterial blood pressure during carotid sinus pressure is a s uitable preimplantation diagnostic tool to predict the success of pace maker therapy, which has shown favorable results during longterm follo w-up.