Blood pressure drop and symptoms during ATP-test under pacing

Symptoms during ATP-test under pacing: Impact on syncope recurrence and prediction from the ATP-test without pacing

“…We had previously hypothesized that these recurrences might be mainly due to vasodilatation [9]. This hypothesis was supported by our previous study in which we found that during DDD paced ATP-test, lower systolic blood pressure (BP) was observed in patients who remained symptomatic under temporary pacing [10]. Considering the role of endogenous adenosine in NMS [11,12], remaining symptoms under paced ATP-test might be associated with higher syncope recurrence due to vasodilatation.…”

“…As previously described [10], after informed consent, bipolar pacing leads have been temporarily inserted through the femoral vein for atrial and ventricular pacing and connected to an external pacer. ATP-tests were performed without (reference ATP-test) and with pacing (VVI and/or DDD).…”

“…Endogenous adenosine released under physiological or pathological conditions could induce bradycardia and/or hypotension and thus provoke syncope [11]. We thus previously suggested that studying BP variations and secondary symptoms during ATP-test under pacing would be an interesting approach to study NMS recurrence in paced patients [10]. Among the patients with positive ATP-test who underwent PM implantation, the only one patient who had a syncope recurrence was still symptomatic during paced ATP-test.…”