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Pacing System Malfunction is a Rare Cause of Hospital Admission for Syncope in Patients with a Permanent Pacemaker

Authors

  • PETER OFMAN M.D., M.S.,

    Corresponding author
    1. Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, Massachusetts
    2. Division of Cardiology, Department of Medicine, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
    3. Division of Aging, Department of Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts
    4. Division of Preventive Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts
    • Department of Cardiology, Hadassah-Hebrew University Medical Center, Ein Karem Campus, Jerusalem, Israel
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  • CATHERINE RAHILLY-TIERNEY M.D., M.P.H.,

    1. Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, Massachusetts
    2. Division of Aging, Department of Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts
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  • LUC DJOUSSE M.D., Sc.D.,

    1. Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, Massachusetts
    2. Division of Aging, Department of Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts
    3. Geriatric Research, Education, and Clinical Center (GRECC), Boston Veterans Affairs Healthcare System, Boston, Massachusetts
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  • ADELQUI PERALTA M.D.,

    1. Division of Cardiology, Department of Medicine, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
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  • PETER HOFFMEISTER M.D.,

    1. Division of Cardiology, Department of Medicine, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
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  • J. MICHAEL GAZIANO M.D., M.P.H.,

    1. Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, Massachusetts
    2. Division of Cardiology, Department of Medicine, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
    3. Division of Aging, Department of Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts
    4. Division of Preventive Medicine, Brigham and Women Hospital and Harvard Medical School, Boston, Massachusetts
    5. Geriatric Research, Education, and Clinical Center (GRECC), Boston Veterans Affairs Healthcare System, Boston, Massachusetts
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  • ALEXEY WEISS M.D.,

    1. Department of Cardiology, Hadassah-Hebrew University Medical Center, Ein Karem Campus, Jerusalem, Israel
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  • CHAIM LOTAN M.D.,

    1. Department of Cardiology, Hadassah-Hebrew University Medical Center, Ein Karem Campus, Jerusalem, Israel
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  • SHIMON ROSENHECK M.D.

    1. Department of Cardiology, Hadassah-Hebrew University Medical Center, Ein Karem Campus, Jerusalem, Israel
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  • Financial support: none.

  • Relationship with industry: none.

Address for reprints: Peter Ofman, M.D., M.S., VA Boston Healthcare System, Department of Medicine, Division of Cardiology, 1400 VFW Parkway, West Roxbury, MA 02132. Fax: 857-203-5575, e-mail: Peter.Ofman@va.gov

Abstract

Background

Few studies have examined the prevalence of permanent pacemaker (PPM) malfunction among patients with a previously implanted pacemaker admitted to the hospital with syncope.

Objective

This study sought to examine causes of syncope in patients with a previously implanted pacemaker admitted to our hospital with syncope.

Methods

We retrospectively reviewed our hospital admission database for patients who had both keywords “syncope” and “pacemaker” as their diagnoses from January 1, 1995 until June 1, 2012. One hundred and sixty-two patients who were admitted to the hospital because of syncope and had a PPM implanted prior to the index syncopal episode were included. All patients had pacemakers interrogated during the admission. Two independent physicians examined the discharge summary of each patient and determined the cause of syncope in each case.

Results

Of the 162 patients studied, eight (4.9%) were found to have pacemaker system malfunction as a cause of syncope. In 96 patients (59.2%), the cause of syncope could not be determined prior to hospital discharge. Among the identifiable causes of syncope, orthostatic hypotension was most prevalent (16%) followed by vasovagal (6%), severe aortic stenosis (4.3%), atrial arrhythmia (3.1%), acute and subacute infection (3.1%), and other less prevalent causes (3.1%).

Conclusion

In this study, PPM system malfunction was rarely a cause of syncope in patients admitted to the hospital with a previously implanted device.

(PACE 2013; 36:109–112)

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