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Issue III registry defines best syncope candidates for cardiac pacing
Date:6/26/2013

treatment of atrial fibrillation for stroke prevention trial) study 4 is currently testing whether early use of rhythm control therapy can prevent adverse cardiovascular outcomes in patients with AF compared to usual care.

ISSUE (international study on syncope of uncertain aetiology)

The second important study at the session, the ISSUE 3 registry, showed that diagnosis of NMS, using ESC guidelines on Diagnosis and Management of Syncope,5 could be confirmed with an implantable loop recorders (ILR) in 87% of patients.

"By showing that NMS tilt-negative asystolic patients benefit most from cardiac pacing, the study inverts previous knowledge on indications for pacing. Prior to this registry, cardiac pacing for NMS had only been evaluated in patients with positive tilt test responses and no indications had existed for patients with negative tilt test results," said Professor Michele Brignole, presenter of the study.

ISSUE was a prospective registry set up to analyse the diagnostic yield of ILRs in specific subgroups of patients with syncope of uncertain aetiology. The registry took place in Italy, Spain, Germany, France, Canada, The Netherlands and UK. For the ISSUE 3 registry, between July 2006 and November 2010, 504 patients with suspected NMS, according to criteria laid down in guidelines, had an implantable loop recorder (IRL) fitted. Entry criteria included being older than 40 years and having experienced more than three episodes of syncope in the previous two years thought to be neurally mediated. Guidelines6 state that a likely diagnosis of NMS can be made when patients have a consistent history and competing diagnoses have been excluded.

Results show that a confirmed diagnosis could be achieved in 187 patients, with ILR findings in 162 of these patients (87%) being consistent with a likely diagnosis of NMS, and IRL findings in 25 patients (13%) allowing NMS to be ruled out. Of the 162 patients with IRL findings sug
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Contact: Jacqueline Partarrieu
press@escardio.org
33-622-418-492
European Society of Cardiology
Source:Eurekalert

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