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Heart Disease (Expert Forum)
Vasovagal Syncope
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Vasovagal Syncope
by chris, Oct 19, 1999 12:00AM
Dear Sirs,
I am a 26 year old male who has been recently diagnosed with vasovagal syncope through a positive tilt table test.
Before I begin to ask any questions, I want to provide you with a summary of my tilt table test. The test was proceeding normally until they started to inject Isoprotenerol by IV. I must have had an inappropriate response to the adrenaline because in a span of two (2) minutes after the IV had started, my heart rate went from 113 bpm to 55 bpm and my blood pressure went from 175/49 to 50/0.
When I awoke, I had about 7 doctors and 2 research specialists by my side to ask questions and perform additional cardio tests because they have never seen such a conclusive positive test, epecially where both the heart rate & blood pressure dropped concurrently.
The research specialists along with the head cardiologist asked if I would consider participating in the "North American Vasovagal Pacemaker Study II." They were quite aggressive in there manner to have me in their study group to the point where I felt they were trying to deter me from enquiring about alternatives to the pacemaker. Reluctantly, they provided me with a list a medications ie beta blockers, disopyramide, sepotonin inhibitors, and alpha-adrenergic agents.
Any assistance that you could provide regarding the "Study" and or the effects of having a pacemaker would help, as well as, any advice regarding the medications noted above?
It appears that I have a tough decision to make in the next couple of weeks and any information you could provide on this matter would be greatly appreciated.
Thank you.
I am a 26 year old male who has been recently diagnosed with vasovagal syncope through a positive tilt table test.
Before I begin to ask any questions, I want to provide you with a summary of my tilt table test. The test was proceeding normally until they started to inject Isoprotenerol by IV. I must have had an inappropriate response to the adrenaline because in a span of two (2) minutes after the IV had started, my heart rate went from 113 bpm to 55 bpm and my blood pressure went from 175/49 to 50/0.
When I awoke, I had about 7 doctors and 2 research specialists by my side to ask questions and perform additional cardio tests because they have never seen such a conclusive positive test, epecially where both the heart rate & blood pressure dropped concurrently.
The research specialists along with the head cardiologist asked if I would consider participating in the "North American Vasovagal Pacemaker Study II." They were quite aggressive in there manner to have me in their study group to the point where I felt they were trying to deter me from enquiring about alternatives to the pacemaker. Reluctantly, they provided me with a list a medications ie beta blockers, disopyramide, sepotonin inhibitors, and alpha-adrenergic agents.
Any assistance that you could provide regarding the "Study" and or the effects of having a pacemaker would help, as well as, any advice regarding the medications noted above?
It appears that I have a tough decision to make in the next couple of weeks and any information you could provide on this matter would be greatly appreciated.
Thank you.
Doctor's Answer
by CCF CARDIO MD - DLB, Oct 19, 1999 12:00AM
I think a pacemaker would probably be a good idea in your case. It may not eliminate your symptoms or the episodes of near-syncope, but would hopefully convert an episode of complete loss of consciousness to just an episode of lightheadedness. Pacemakers have been used for years in patients with vasovagal syncope; the study is just trying to prove that this approach is indeed scientifically valid.
The first time this happened, I was lying on the bed on my tummy, as I lifted my head back, my whole body started buzzing and my heart rate slowed down to the 30's. It took every bit of my being to force myself off of my tummy and onto my side to stop what was happening to me. Makes me wonder if I had not rolled over, what would have happened? Would I have died? It surely felt like I was leaving for good.
Thanks for your time, Gail
My only comment to you is that I would try everything else before going to a pacemaker. I would also recommend seeing a cardiologist that specializes in syncope. The one I found happened to have trained at the Cleveland Clinic.
Good Luck!