© 2002 by European Society of Cardiology
REGULAR ARTICLES
Prevalence of hypotensive disorders in older patients with a pacemaker in situ who attend the Accident and Emergency Department because of falls or syncope
1Cardiovascular Investigation Unit, Victoria Wing, Royal Victoria Infirmary Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, U.K.; 2Department of Cardiology, Freeman Hospital, Freeman Road, High Heaton Newcastle upon Tyne, NE7 7DN, U.K.
Manuscript submitted 15 May 2001. Accepted after revision 20 January 2002.
Correspondence: Professor R. A. Kenny, Cardiovascular Investigation Unit, Victoria Wing, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, U.K. E-mail: r.a.kenny{at}ncl.ac.uk
Key Words: Pacemaker, Accident and Emergency, syncope, hypotension
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Aims |
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 Top Aims Methods and resultsConclusionReferences |
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To ascertain the proportion of adults with a pacemaker in situ attending the Accident and Emergency Department because of syncope or unexplained falls and the cause of index symptoms in these patients, including the prevalence of hypotensive syndromes.
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Methods and results |
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TopAimsMethods and resultsConclusionReferences |
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Patients presenting to the Accident and Emergency Department with unexplained syncope or non-accidental falls, who had a pacemaker in situ, were studied. Eligible patients had cardiovascular assessment (morning orthostatic blood pressure measurement, heart rate and BP measurements during carotid sinus stimulation (supine and upright), head-up tilt at 70° for 40 min), assessment of haemodynamics during fixed mode pacing and gait and balance assessment.
Of 5863 patients screened, 13·5% had unexplained syncope or a non-accidental fall; of these only 3% (26 patients) had pacemakers in situ. Of 18 study patients (82±8 years), 10 were female. Sixteen had a hypotensive diagnosis. Seven had more than one attributable hypotensive diagnosis. Five of 13 with vasodepressor carotid sinus syndrome had no previous diagnosis of carotid sinus hypersensitivity. No patients had vasovagal syncope induced during passive head-up tilt testing.
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Conclusion |
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TopAimsMethods and resultsConclusionReferences |
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It is rare for patients who attend the Accident and Emergency Department because of syncope or unexplained falls to have a pacemakerin situ . In those who do, hypotensive disorders are a common finding.
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References |
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