PERMANENT CARDIAC PACING IN ELDERLY PATIENTS WITH RECURRENT FALLS, DIZZINESS AND SYNCOPE, AND A HYPERSENSITIVE CARDIOINHIBITORY REFLEX

The study was designed to assess the outcome of treatment with permane nt dual-chamber pacing of elderly patients with falls, dizziness and s yncope associated with the demonstration of a hypersensitive cardioinh ibitory reflex. Questionnaires were sent to patients (and their genera l practitioners) who had been referred to a regional pacing centre wit h recurrent falls, dizziness or syncope diagnosed as likely to be seco ndary to cardioinhibitory carotid sinus syndrome or predominantly card ioinhibitory vasovagal syndrome. After pacemaker insertion, 84% of pat ients had no further syncope over a mean follow-up period of 10 (range 1.5 to 30) months. Minor symptoms persisted in only 40% of all patien ts, Symptoms were unchanged in 22%. It was concluded that permanent du al-chamber pacing is an effective treatment for elderly patients with recurrent falls, dizziness and syncope in whom a hypersensitive cardio inhibitory reflex is found. Good results were obtained in this group w ith a simple diagnostic work-up.