Treatment of unexplained syncope: A multicenter, randomized trial of cardiac pacing guided by adenosine 5′-triphosphate testing

Circulation

Volumn 125, Issue 1, 2012, Pages 31-36

  Flammang, Daniel ^a   Church, Timothy R ^b   De Roy, Luc ^c   Blanc, Jean Jacques ^d   Leroy, Jean ^e   Mairesse, Georges H ^f   Otmani, Akli ^g,k   Graux, Pierre J ^h   Frank, Robert ⁱ   Purnode, Philippe ^j  

^a CROIX ROUSSE HOSPITAL   (France)

^b UNIVERSITY OF MINNESOTA   (United States)

^c UNIVERSITÉ CATHOLIQUE DE LOUVAIN   (Belgium)

^d BREST UNIVERSITY HOSPITAL   (France)

^e Gosselies and Gilly General Hospitals   (Belgium)

^f Arlon General Hospital   (Belgium)

^g AMIENS UNIVERSITY HOSPITAL   (France)

^h Saint Philibert Hospital   (France)

ⁱ PITIÉ SALPÊTRIÈRE HOSPITAL   (France)

^j St Jean Hosp   (Belgium)

^k HÔPITAL EUROPÉEN GEORGES POMPIDOU   (France)

more..

Author keywords

adenosine triphosphate; pacemaker, artificial; randomized controlled trials; syncope; syncope, vasovagal

Indexed keywords

ADENOSINE TRIPHOSPHATE;

AGED; ARTICLE; ATRIOVENTRICULAR BLOCK; CARDIOVASCULAR RISK; CONTROLLED STUDY; DISEASE SEVERITY; FEMALE; FOLLOW UP; HEART ATRIUM PACING; HEART PACING; HEART RATE; HEART SINOATRIAL BLOCK; HUMAN; HYPERTENSION; IDIOPATHIC DISEASE; ISCHEMIC HEART DISEASE; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; PACEMAKER; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RECURRENCE RISK; RECURRENT DISEASE; SEX DIFFERENCE; SINGLE BLIND PROCEDURE; SYNCOPE; TREATMENT OUTCOME; VALVULAR HEART DISEASE;

ADENOSINE TRIPHOSPHATE; AGED; AGED, 80 AND OVER; CARDIAC PACING, ARTIFICIAL; FEMALE; FOLLOW-UP STUDIES; HUMANS; MALE; MIDDLE AGED; SINGLE-BLIND METHOD; SYNCOPE; TREATMENT OUTCOME;

EID: 84855396605     PISSN: 00097322     EISSN: 15244539     Source Type: Journal    
DOI: 10.1161/CIRCULATIONAHA.111.022855     Document Type: Article

References (30)

1. Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, Deharo JC, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Granell RR, Sarasin F, Ungar A, van Dijk JG, Walma EP, Wieling W, Abe H, Benditt DG, Decker WW, Grubb BP, Kaufmann H, Morillo C, Olshansky B, Parry SW, Sheldon R, Shen WK, Vahanian A, Auricchio A, Bax J, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, McGregor K, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, Acarturk E, Andreotti F, Asteggiano R, Bauersfeld U, Bellou A, Benetos A, Brandt J, Chung MK, Cortelli P, Da Costa A, Extramiana F, Ferro J, Gorenek B, Hedman A, Hirsch R, Kaliska G, Kenny RA, Kjeldsen KP, Lampert R, Molgard H, Paju R, Puodziukynas A, Raviele A, Roman P, Scherer M, Schondorf R, Sicari R, Vanbrabant P, Wolpert C, Zamorano JL. Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Eur Heart J. 2009;30:2631-2671.
2. Blanc JJ, L'Her C, Touiza A, Garo B, L'Her E, Mansourati J. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J. 2002;23:815-820. (Pubitemid 35238496)
3. Nyman JA, Krahn AD, Bland PC, Griffiths S, Manda V. The costs of recurrent syncope of unknown origin in elderly patients. Pacing Clin Electrophysiol. 1999;22:1386-1394. (Pubitemid 29485040)
4. Kenny DD, O'Shea D, Walker HF. Impact of a dedicated syncope and falls facility for older adults on emergency beds. Age Aging. 2002;31: 272-275.
5. World Health Organization. Life tables. http://www.Who.Int/whosis/ database/life-tables/life-tables.Cfm. Accessed May 12, 2011.
6. Kenny RA, Ingram A, Bayliss J, Sutton R. Head-up tilt: a useful test for investigating unexplained syncope. Lancet. 1986;1:1352-1355. (Pubitemid 16121891)
7. Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, Levy D. Incidence and prognosis of syncope. N Engl J Med. 2002;347: 878-885.
8. Flammang D, Luizy J, Waynberger M. The adenosine-5-triphosphate test in the appraisal of the vasovagal syndrome assessment of the best therapy Presented at: 10th World Congress of Cardiology. Washington, DC; 1986.
9. Flammang D, Church T, Waynberger M, Chassing A, Antiel M. Can adenosine 5-triphosphate be used to select treatment in severe vasovagal syndrome? Circulation. 1997;96:1201-1208. (Pubitemid 27344224)
10. Wu M, Fisher M, DeMets D. Sample sizes for long term medical trial with time dependent dropout and event rates. Control Clin Trials. 1980; 1:109-121.
11. Flammang D, Antiel M, Church T, Chassing A, Hamani D, Donal E, Waynberger M. Is a pacemaker indicated for vasovagal patients with severe cardioinhibitory reflex as identified by the ATP test? A preliminary randomized trial. Europace. 1999;1:140-145.
12. Flammang D, Chassing A, Donal E, Hamani D, Erickson M, McCarville S. Reproducibility of the adenosine-5-triphosphate test in vasovagal syndrome. J Cardiovasc Electrophysiol. 1998;9:1161-1166. (Pubitemid 28516143)
13. Motte G, Waynberger M, Lebards A, Bouvrain Y. Adenosine triphosphate in paroxysmal tachycardia: diagnostic and therapeutic value [in French]. Nouv Presse Med. 1972;1:3057-3061.
14. Belhassen B, Fish R, Glikson M, Glick A, Eldar M, Laniado S, Viskin S. Noninvasive diagnosis of dual AV node physiology in patients with AV nodal reentrant tachycardia by administration of adenosine-5-triphosphate during sinus rhythm. Circulation. 1998;98:47-53. (Pubitemid 28312078)
15. Parry SW, Nath S, Bourke JP, Bexton RS, Kenny RA. Adenosine test in the diagnosis of unexplained syncope: marker of conducting tissue disease or neurally mediated syncope? Eur Heart J. 2006;27:1396-1400. (Pubitemid 43998071)
16. Munoz A, Sassine A, Lehujeur C, Koliopoulos N, Puech P. Mode of action of purinergic derivatives of adenine on auriculo-ventricular conduction: experimental study in dogs [in French]. Arch Mal Coeur Vaiss. 1985;78:143-150.
17. Pelleg A, Hurt CM. Mechanism of action of ATP on canine pulmonary vagal C fibre nerve terminals. J Physiol. 1996;490:265-275. (Pubitemid 26022468)
18. Pelleg A, Katchanov G, Xu J. Autonomic neural control of cardiac function: modulation by adenosine and adenosine 5-triphosphate. Am J Cardiol. 1997;79:11-14. (Pubitemid 27312485)
19. Xu J, Kussmaul W, Kurnik PB, Al-Ahdav M, Pelleg A. Electrophysiological- anatomic correlates of ATP-triggered vagal reflex in the dog, V: role of purinergic receptors. Am J Physiol Regul Integr Comp Physiol. 2005;288:R651-R655. (Pubitemid 40250575)
20. Brignole M, Deharo JC, De Roy L, Menozzi C, Blommaert D, Dabiri L, Ruf J, Guieu R. Syncope due to idiopathic paroxysmal atrioventricular block long-term follow-up of a distinct form of atrioventricular block. J Am Coll Cardiol. 2011;58:167-173.
21. Parry SW, Chadwick T, Gray JC, Bexton RS, Tynan M, Bourke JP. The intravenous adenosine test: a new test for the identification of bradycardia pacing indications? A pilot study in subjects with bradycardia pacing indications, vasovagal syncope and controls. Q J Med. 2009;102: 461-468.
22. Brignole M, Gaggioli G, Menozzi C, Gianfranchi L, Bartoletti A, Bottoni N, Lolli G, Oddone D, Del Rosso A, Pellinghelli G. Adenosine-induced atrioventricular block in patients with unexplained syncope: the diagnostic value of ATP testing. Circulation. 1997;96:3921-3927.
23. Brignole M, Sutton R, Menozzi C, Garcia-Civera R, Moya A, Wieling W, Andresen D, Benditt DG, Grovale N, De Santo T, Vardas P. Lack of correlation between the responses to tilt testing and adenosine triphosphate test and the mechanism of spontaneous neurally mediated syncope. Eur Heart J. 2006;27:2232-2239. (Pubitemid 44412839)
24. Perennes A, Fatemi M, Borel ML, Lebras Y, L'Her C, Blanc JJ. Epidemiology, clinical features, and follow-up of patients with syncope and a positive adenosine triphosphate test result. J Am Coll Cardiol. 2006;47: 594-597. (Pubitemid 43170850)
25. Deharo JC, Jego C, Lanteaume A, Djiane P. An implantable loop recorder study of highly symptomatic vasovagal patients: the heart rhythm observed during a spontaneous syncope is identical to the recurrent syncope but not correlated with the head-up tilt test or adenosine triphosphate test. J Am Coll Cardiol. 2006;47:587-593. (Pubitemid 43170849)
26. Brignole M, Sutton R, Menozzi C, Garcia-Civera R, Moya A, Wieling W, Andresen D, Benditt DG, Vardas P. Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope. Eur Heart J. 2006;27:1085-1092.
27. Krahn AD, Klein GJ, Norris C, Yee R. The etiology of syncope in patients with negative tilt table and electrophysiological testing. Circulation. 1995;92:1819-1824.
28. Moya A, Brignole M, Menozzi C, Garcia-Civera R, Tognarini S, Mont L, Botto G, Giada F, Cornacchia D. Mechanism of syncope in patients with isolated syncope and in patients with tilt-positive syncope. Circulation. 2001;104:1261-1267. (Pubitemid 32848115)
29. Steering Committee of the ISSUE 3 Study. International Study on Syncope of Uncertain Aetiology (ISSUE 3): pacemaker therapy for patients with asystolic neurally-mediated syncope: rationale and study design. Europace. 2007;9:25-30.
30. Pelleg A, Hurt C, Miyagawa A, Michelson EL, Dreifus LS. Differential sensitivity of cardiac pacemakers to exogenous adenosine in vivo. Am J Physiol. 1990;258:H1815-H1822. (Pubitemid 20226317)