Exames diagnósticos de síncopes em portadores de marca‑passo cardíaco

Abstract

Introduction: Syncopes may represent a high risk of morbidity and mortality in certain populations. Objective: To investigate the results of complementary methods used in the diagnosis of syncope in patients with pacemakers (PM). Methods: Participants from the Arrhythmias and Pacemaker Outpatient Unit of the University Hospital Walter Cantídio were recruited. Patients with uni or bicameral PM implanted in the last 10 years due to sinus node or atrioventricular block, with analytical capacity of endocavitary electrograms (EGM) were included and assessed clinically by specific questionnaires and EGM analysis. Other tests were ordered according to clinical suspicion, such as the 24h Holter, Tilt test, Carotid sinus hypersensitivity test or an electrophysiology study. Results: The Tilt test diagnosed vasovagal syncopes in almost 1/3 of the cases. The computerized analysis of the EGM presented a high diagnostic capacity, having determined the arrhythmic etiology or PM failures in 27.6% of the cases. Holter 24hs assisted in the investigation in 18.7% of the cases. Conclusion: Pacemaker tests with their stored electrograms and Tilt test were the best methods for etiological diagnosis of syncope in patients with cardiac pacemaker.