A pacemaker may help reduce or eliminate the risk of fainting in certain patients
The first effective therapy for fainting has been identified, according to research presented at the European Society of Cardiology Congress 2020.
One in 2 people will suffer from fainting during their lifetime. Those with recurrent episodes are often fearful of socializing or going to work, according to the study authors.
Fainting is caused by a flood in blood pressure or the number of heart beats. For some patients, fainting is triggered by events such as emotional stress, standing in a hot and crowded space, or sitting up too quickly.
These patients tend to also have warning signs such as weakness, dizziness, or nausea; however, in many patients, especially order adults, there are no triggers or warning signs. Currently, no specific treatment exists outside of generic prevention advice, such as keeping hydrated and avoiding hot, crowded, environments.
Researchers sought to determine whether a pacemaker could prevent unpredictable fainting caused by missed heart beats. Researchers identified patients with this particular kind of fainting using the tilt test.
This test involves lying on a table that is slowly titled upward to simulate standing up. Blood pressure and heart rate are monitored during the test. In 128 patients over the age of 40 who had fainted at least twice during the last year, the tilt test showed that fainting was caused by a missed heartbeat, according to the researchers.
All participants in the study were issued a pacemaker; however, they were randomly assigned to have their pacemaker switched on or off. The study had a median follow-up of 11.2 months.
Only 16% of those in the group with the pacemaker switched on, or the pacing group, fainted during the study period; however, in the control group, 53% of those patients had an episode.
Those in the pacing group had a 77% lower risk of fainting than those in the control group and those in the pacing group showed a 46% absolute risk reduction.
"Our study shows that pacing can be an effective treatment for selected people with unpredictable fainting episodes. Tilt testing is a simple and non-invasive way to identify people who could benefit. We hope this new treatment option will enable these patients to resume a normal life without fear of blackouts,” Michele Brignole, MD, principal investigator and professor of the Faint and Fall Programme, Istituto Auxologico, Milan, Italy, said in the press release.
If 11 patients received a pacemaker, fainting could be avoided in 5 patients, according to the study. Minor adverse events, such as lead-related complications, were seen in 4% of patients.
First treatment identified for fainting (Press release), Sophia Antipolis, France, September 1, 2020, EurekAlert!, Accessed September 1, 2020