[Long-term prognosis in patients with vasovagal syncope after pacemaker implantation]. / Rokowanie odlegle u pacjentów z omdleniami wazowagalnymi po implantacji kardiostymulatora.

Patients with syncope, without presence of a structural or primary electrical disease, have a very good prognosis. On the other hand, recurring syncope has a negative impact on quality of life and involves a real risk of physical injuries. Vasovagal syncope usually requires no medical therapy and the most commonly recommended instruction include avoidance of fainting triggers, exercise that mainly provoke leg muscles tension, increase salt consumption and drink indicated amount of fluids. In the case cardioinhibitory type of vasovagal syncope the pacemaker implantation can consider. Unfortunately, not all patients benefit from this treatment. Medical society clearly highlights that proper qualification of VVS patients is the most important factor for cardiostimulator implantation. This article aims to summarize the most important research and guidelines concerning cardiac pacing for patients with vasovagal syncope.

[Technical options of electrotherapy in patients with vasovagal syncope]. / Techniczne mozliwosci elektroterapii u osób z omdleniami wazowagalnymi.

Syncope is a symptom of the disease with diverse etiology and can be evidence of both benign and very serious life-threatening conditions. Vasovagal syncope(VVS), with prevalence about 35% of the general population, is most frequent causes of transient loss of consciousness (T-LOC). Most cases of vasovagal syncope requires conservative treatment. Although cardioinhibitory type of VVS characterized by a significant bradycardia or pause of the heart rate and can be treated with continuous electrotherapy. This article discuss cardiac pacing and technical solutions for the treatment of VVS. Available cardiac pacing methods used to detect and break VVS such as Rate Drop Response (RDR), Closed Loop Stimulation (CLS) and rate response driven by variations of myocardial contractility like Peak Endocardial Acceleration (PEA), has been presented.

[Baroreflex sensitivity: measurement and clinical aspects]. / Odruch z baroreceptorów tetniczych: metody oceny i zastosowanie kliniczne.

Homeostasis of blood pressure is indispensable for proper functioning of the body. Sympathetic and parasympathetic part of the autonomic nervous system (ANS), acting on the principle of negative feedback, ensure fast and efficient regulation of blood pressure. A key element in this process is the arterial baroreceptor reflex (BR). Disorders of BR play a significant role in the development and progression of many diseases of the cardiovascular system. Baroreflex sensitivity (BRS) and heart rate turbulence (HRT) are indicators of ANS function. Many clinical trials confirmed the value of ANS function assessment in risk stratification of patients with diseases such as hypertension, coronary artery disease, congestive heart failure, diabetes and stroke. Neither BRS nor HRT can be assessed in patients with atrial fibrillation and flutter, sino-atrial and atrioventricular blocks or in patients with pacemakers. Analysis of these indicators is therefore limited to a group of patients in sinus rhythm.