Abstract | PURPOSE: To review the current clinical experience with new and expanding indications for permanent cardiac pacing. DATA SOURCES: STUDY SELECTION: Because published reports in these areas are scarce, all of the peer-reviewed articles and most of the relevant abstracts found were reviewed. DATA EXTRACTION: Data were manually extracted from the various sources, and the reports were classified and summarized according to specific indications. RESULTS: Pacing is becoming an important option in the treatment of patients with symptomatic drug-resistant hypertrophic obstructive cardiomyopathy. Symptomatic and hemodynamic benefits have been shown in patients with pacing over various periods of follow-up. In patients with the long QT syndrome in whom medical therapy had failed, pacing at relatively fast rates markedly reduced symptoms and almost completely abolished fainting spells. Preliminary results suggest that pacing may be beneficial in dilated cardiomyopathy and in preventing episodes of paroxysmal atrial fibrillation. Further studies are needed to clarify the mechanisms of and to improve selection criteria for pacing in these conditions. Our ability to select cardiac transplant recipients for permanent pacing and our ability to optimize the timing of pacing in these patients have recently improved considerably. The role of pacing therapy in patients with neurally mediated ( vasovagal) syncope remains incompletely understood. Better classification of these patients, made according to the sequence of hemodynamic events leading to syncope, is likely to clarify the potential benefit of pacing in these patients and improve the selection of patients for pacing. CONCLUSION: Few peer-reviewed clinical trials have been done, and further studies are needed to confirm the promising effects of pacing in patients with these newly recognized and expanding indications for pacing.
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Authors | M Glikson, R E Espinosa, D L Hayes |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 123
Issue 6
Pg. 443-51
(Sep 15 1995)
ISSN: 0003-4819 [Print] United States |
PMID | 7639445
(Publication Type: Journal Article, Review)
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Topics |
- Atrial Fibrillation
(prevention & control)
- Cardiac Pacing, Artificial
- Cardiomyopathies
(physiopathology, therapy)
- Heart Transplantation
- Hemodynamics
- Humans
- Long QT Syndrome
(therapy)
- Syncope
(therapy)
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