|
|
|
|
During the initial tilt test,6 patients had asystole and 16 had bradycardia along with hypotension.Despite artificial pacing,the mean arterial pressure during head-up tilt testing still fell significantly, from 97+/=19 to 57+/=19 mmHg(P<0.001);5 patients had syncope,and 15 had presyncope.By contrast,19 patients who later received only medical therapy (metoprolol in 10,theophylline in 3,and disopyramide in 6),2 patients who received both metoprolol and atrioventricular sequential pacing and negative head-up tilt tests.After a median follow-up of 16 months,18 of the 19 patients who were treated with drugs alone(94%)remained free of recurrent syncope or presyncope,whereas the patient treated only with a permanent dual-chamber pacemaker had recurrent syncope.In patients with neurocardiogenic syncope associated with bradycardia or asystole,drug therapy is often effective in preventing syncope,whereas artificial pacing is not. |
|