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The role of cardiac pacing in carotid sinus syndrome: a meta-analysis

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Abstract

Purpose

Cardiac pacing can be used to treat carotid sinus syndrome (CSS), but clinical studies have shown conflicting results. We conducted a systematic review and meta-analysis to evaluate the role of pacing for CSS.

Methods

A systematic search of publications in PubMed, Embase, and the Cochrane Library without language restriction was performed. Prospective randomized studies that compared cardiac pacing with standard therapy or pacing with different algorithms were included if the recurrence of syncope or the number of falls was observed.

Results

Eight studies enrolling 540 patients were identified. In open-label studies, the recurrence of syncope was reduced significantly by cardiac pacing compared with standard therapy. The recurrence of syncope was not different between single- and dual-chamber pacing, but a lower rate of patients with pre-syncope was observed in the group with dual-chamber pacing. Double-blind clinical studies failed to observe the role of cardiac pacing for preventing falls in patients with CSS.

Conclusion

The results of meta-analysis supported the use of cardiac pacing for patients with dominant cardioinhibitory CSS.

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Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Beijing, 100037, People’s Republic of China

    Bing-Wei Chen, Zhi-Guang Wang, Na-Qiang Lv, Yan-Mei Cheng & Ai-Min Dang

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  1. Bing-Wei Chen
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  2. Zhi-Guang Wang
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  3. Na-Qiang Lv
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  4. Yan-Mei Cheng
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  5. Ai-Min Dang
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Corresponding author

Correspondence to Ai-Min Dang.

Appendices

Appendix 1: Search strategies

PubMed

#1 “carotid sinus hypersensitivity”

#2 “carotid sinus syndrome”

#3 #1 OR #2

#4 “Cardiac Pacing, Artificial”[Mesh] OR “Pacemaker, Artificial”[Mesh]

#5 pacemaker*

#6 pacing*

#7 #4 OR #5 OR #6

#8 #3 AND #7

EMBASE

#1 “carotid sinus hypersensitivity”

#2 “carotid sinus syndrome” /exp

#3 #1 OR #2

#4 pacemaker*

#5 pacing*

#6 “artificial pacemaker” /exp

#7 “cardiac pacing”/exp

#8 “heart pacing”/exp

#9 #4 OR #5 OR #6 OR #7 OR #8

#9 #3 AND #9

Cochrane Library

#1 “carotid sinus hypersensitivity”

#2 “carotid sinus syndrome”

#3 #1 or #2

#4 pacemaker*

#5 pacing*

#6 #4 or #5

#7 #3 and #6

Appendix 2: Data extraction form—cardiac pacing and carotid sinus syndrome

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Chen, BW., Wang, ZG., Lv, NQ. et al. The role of cardiac pacing in carotid sinus syndrome: a meta-analysis. Clin Auton Res 24, 127–134 (2014). https://doi.org/10.1007/s10286-014-0238-x

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  • DOI: https://doi.org/10.1007/s10286-014-0238-x

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