Treatment of Unexplained Syncope: A Multicenter, Randomized Trial of Cardiac Pacing Guided by Adenosine 5 -triphosphate Testing Running title: Flammang et al.; ATP test to select pacing in unexplained syncope

Treatment of Unexplained Syncope A Multicenter, Randomized Trial of Cardiac Pacing Guided by Adenosine 5 -Triphosphate Testing

Letter by Lagro et al regarding article, "Treatment of unexplained syncope: a multicenter, randomized trial of cardiac pacing guided by adenosine 5'-triphosphate testing".

BACKGROUND The origin of 40% of syncope cases remains unknown even after a complete diagnostic workup. Previous studies have suggested that ATP testing has value in selecting successful therapy. This patient-blinded, multicenter, randomized superiority trial tested whether, in patients with syncope of unknown origin, selecting cardiac pacing in those with a positive ATP test leads to fewer recu...

Adenosine 5'-Triphosphate Test in the Management of Patients With Syncope.

The response to adenosine 5'-triphosphate (ATP) identifies patients with syncope who might benefit from pacemaker therapy (ATP test). Two measures have been used to determine the outcome of the ATP test, which have lead to contrasting conclusions regarding its utility: (1) the duration of cardiac pause (CP) mainly due to AV block and (2) the longest RR interval (RRmax). We tested the hypothesis...

Upgrading from ventricular to physiological pacing: is it worth it?

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Should the 'adenosine-challenge test' be part of the routine work-up for syncope?

The adenosine compounds [adenosine and adenosine triphosphate (ATP)] exert negative chronotropic and dromotropic effects at the level of the sinus node and atrio-ventricular (AV) node. These effects are both potent and short lasting. Therefore, the adenosine compounds replaced verapamil as the first-line drug for terminating re-entrant supraventricular tachycardias involving the AV node (AV nod...