Unexplained Syncope—A Diagnostic Pacemaker?

Abstract

We describe our initial experience with a pacemaker which performs the dual function of registering episodes of cardiac arrest and pacing the heart when necessary. The apparatus has a prolonged escape interval (2.30-2.65 seconds) and is capable of counting up to 128 "events." Twenty-five patients complaining of infrequent episodes of loss of consciousness have been studied. Blackouts ceased and episodes of ventricular standstill were recorded in 14 cases; the unit helped to establish a non-cardiac etiology for the attacks in two cases. It is suggested that a bradycardia-recording facility incorporated into a programmable pacemaker would provide a much needed tool in the diagnosis and management of patients with infrequent episodes of loss of consciousness in whom a cardiac mechanism is suspected but unproven.

Syncope: Overview and Approach to Management

“…In the elderly, the empiric placement of a pacemaker has been considered an option but this remains highly controversial [311][312][313][314][315]. It has been shown with extensive monitoring that transient bradyarrhythmias can be diagnosed as the cause for syncope when no other cause can be found [223].…”

Pacemaker Stored Electrograms: Teaching Us What Is Really Going On in Our Patients

“…One of the earliest examples of diagnostics in a pacemaker was reported in 1983 in which diagnostics were used for the management of patients with unexplained syncope. 1 The therapeutic and diagnostic capabilities of pacemakers, while far from complete, continue to undergo development. 2 Yet the resulting complexity and sophistication can pose challenges in assessing proper device function.…”