Estimulación con marcapasos para disminuir recurrencias en pacientes adultos con síncope vasovagal: una revisión sistemática

Abstract

Introduction: Vasovagal syncope is the leading cause of transient loss of consciousness. International guidelines recommend in the treatment of syncope with a weak level of evidence, pacemaker implantation for patients refractory to medical treatment and with a cardioinhibitory response. To date there is no systematic review to summarize the best available evidence of pacing in vasovagal syncope to reduce recurrences. Methods: Systematic review of the literature with randomized clinical trials on the use of pacemakers in vasovagal syncope to reduce recurrences. Results: The initial search yielded a total of 299 results, of which only 8 met the selection criteria. Recurrence of syncope in the pacing group compared to the group without stimulation was evaluated. With marked methodological differences in the studies included in general, there is no solid evidence to ensure that pacemaker decreases recurrence of vasovagal syncope. Discussion: Pacing in vasovagal syncope has no beneficial effect on decreasing recurrence in the whole population refractory to medical treatment to reduce recurrences. Only a group with highly selected clinical characteristics may benefit from pacing to reduce recurrence of syncope. Conclusion: The available evidence suggests that pacing has no effect on reduction of recurrence in the whole group of patients with vasovagal syncope refractory to medical treatment.