Current concepts in the evaluation and management of syncope

Current Cardiology Reports

Volumn 10, Issue 5, 2008, Pages 384-390

  Kuriachan, Vikas ^a   Sheldon, Robert S ^a  

^a UNIVERSITY OF CALGARY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT; FLUDROCORTISONE; FLUOXETINE; METOPROLOL; MIDODRINE; PAROXETINE; PLACEBO; PROPRANOLOL; SEROTONIN UPTAKE INHIBITOR; ANTIINFLAMMATORY AGENT; VASOCONSTRICTOR AGENT;

ACUTE CORONARY SYNDROME; ANAMNESIS; CARDIOVASCULAR DISEASE; CLINICAL ASSESSMENT TOOL; CLINICAL DECISION MAKING; CLINICAL TRIAL; CONCEPT ANALYSIS; DEFIBRILLATION; DIAGNOSTIC ACCURACY; DIFFERENTIAL DIAGNOSIS; DRUG CHOICE; DRUG DOSE TITRATION; DRUG EFFECT; DRUG EFFICACY; DRUG ERUPTION; DRUG MECHANISM; DRUG RESPONSE; DRUG SAFETY; DRUG TOLERABILITY; ELECTROCARDIOGRAPHY; HEAD TILTING; HEART PACING; HIGH RISK PATIENT; HUMAN; HYPERTENSION; HYPOTENSION; MEDICAL DECISION MAKING; NAUSEA; PARESTHESIA; PHYSICAL EXAMINATION; PRACTICE GUIDELINE; PRESYNCOPE; PROGNOSIS; RECURRENT DISEASE; REFLEX; RESUSCITATION; REVIEW; RISK ASSESSMENT; SCORING SYSTEM; SENSITIVITY AND SPECIFICITY; SIDE EFFECT; SUDDEN DEATH; SYMPTOM; SYNCOPE; TREATMENT DURATION; UNCONSCIOUSNESS; HOSPITALIZATION; RANDOMIZED CONTROLLED TRIAL; TILT TABLE TEST;

ADRENERGIC BETA-ANTAGONISTS; ANTI-INFLAMMATORY AGENTS; CARDIAC PACING, ARTIFICIAL; FLUDROCORTISONE; GUIDELINES AS TOPIC; HUMANS; MIDODRINE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SEVERITY OF ILLNESS INDEX; SYNCOPE; TILT-TABLE TEST; VASOCONSTRICTOR AGENTS;

EID: 58149139683     PISSN: 15233782     EISSN: None     Source Type: Journal    
DOI: 10.1007/s11886-008-0061-x     Document Type: Review

References (42)

1. Fitzpatrick A, Cooper P: Diagnosis and management of patients with blackouts. Heart 2006, 92: 559-568.
2. Costantino G, Perego F, Dipaola F, et al.: Short-and long-term prognosis of syncope risk factors, and role of hospital admission: Results from the STePS (Short-Term Prognosis of Syncope) study. J Am Coll Cardiol 2008, 51: 276-283.
3. Serletis A, Rose S, Sheldon AG, Sheldon RS: Vasovagal syncope in medical students and their first-degree relatives. Eur Heart J 2006, 27: 1965-1970.
4. Ganzeboom KS, Mairuhu G, Reitsma JB, et al.: Lifetime cumulative incidence of syncope in the general population: A study of 549 Dutch subjects aged 35-60 years. J Cardiovasc Electrophysiol 2006, 17: 1172-1176.
5. Sheldon R, Morillo CA, Krahn A: Management of vasovagal syncope: 2004. Expert Rev Cardiovas Ther 2004, 2: 915-923.
6. Gould PA, Krahn AA, Klein GJ, et al.: Investigating syncope: a review. Curr Opin Cardiol 2006, 21: 34-41.
7. Smars PA, Decker WW, Shen WK.: Syncope evaluation in the emergency department. Curr Opin Cardiol 2007, 22: 44-48.
8. Brignole M: Diagnosis and treatment of syncope. Heart 2007, 93: 130-136.
9. Brignole M, Alboni P, Benditt D, et al.: Guidelines on management of syncope - update 2004. Europace 2004, 6: 467-537.
10. Sheldon R, Rose S, Connolly S, et al.: Diagnostic criteria for vasovagal syncope based on a quantitative history. Eur Heart J 2006, 27: 344-350.
11. Sheldon RS, Sheldon AG, Connolly SJ, et al.: Age of first faint in patients with vasovagal syncope. J Cardiovasc Electrophysiol 2006, 17: 49-54.
12. Raj SR, Rose S, Ritchie D, et al.: The Second Prevention of Syncope Trial (POST II)-a randomized clinical trial of fludrocortisone for the prevention of neurally mediated syncope: Rationale and study design. Am Heart J 2006, 151: 1186.e11-1186.e17.
13. Colivicchi F, Ammirati F, Melina D, et al.: Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: The OESIL risk score. Eur Heart J 2003, 24: 811-819.
14. Reed MJ, Newby DE, Coull AJ, et al.: The Risk Stratification Of Syncope in the Emergency department (ROSE) pilot study: A comparison of existing syncope guidelines. Emerg Med J 2007, 24: 270-275.
15. Quinn J, Stiell I, McDermott D, et al.: Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med 2004, 43: 224-232.
16. Quinn JV, Stiell IG, McDermott DA, et al.: The San Francisco Syncope Rule vs physician judgment and decision making. Am J Emerg Med 2005, 23: 782-786.
17. Cosgriff TM, Kelly AM, Kerr D: External validation of the San Francisco Syncope Rule in the Australian context. Can J Emerg Med 2007, 9: 157-161.
18. Grossman SA, Fischer C, Lipsitz LA, et al.: Predicting adverse outcomes in syncope. J Emerg Med 2007, 33: 233-239.
19. Munger TM, Gersh BJ, Hammill SC, et al.: Syncope Evaluation in the Emergency Department Study (SEEDS): A multidisciplinary approach to syncope management. Circulation 2004, 110: 3636-3645.
20. Brignole M, Menozzi C, Bartoletti A, et al.: A new management of syncope: Prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J 2006, 27: 76-82.
21. Wieling W, Van Lieshout JJ, Hainsworth R: Extracellular fluid volume expansion in patients with posturally related syncope. Clin Auton Res 2002, 12: 242-249.
22. van Dijk N, de Bruin IG, Gisolf J, et al.: Hemodynamic effects of leg crossing and skeletal muscle tensing during free standing in patients with vasovagal syncope. J Appl Physiol 2005, 98: 584-590.
23. Krediet CT, van Lieshout JJ, Bogert LW, et al.: Leg crossing improves orthostatic tolerance in healthy subjects: A placebo-controlled crossover study. Am J Physiol Heart Circ Physiol 2006, 291: H1768-H1772.
24. van Dijk N, Quartieri F, Blanc JJ, et al.: Effectiveness of physical counterpressure maneuvers in preventing vasovagal syncope: The Physical Counterpressure Manoeuvres Trial (PC-Trial). J Am Coll Cardiol 2006, 48: 1652-1657.
25. Sagrista-Sauleda J, Romero B, Permanyer-Miralda G, et al.: Reproducibility of sequential head-up tilt testing in patients with recent syncope, normal ECG and no structural heart disease. Eur Heart J 2002, 23: 1706-1713.
26. Ector H, Willems R, Heidbuchel H, Raybrouck T: Repeated tilt testing in patients with tilt positive neurally mediated syncope. Europace 2005, 7: 628-633.
27. Reybrouck T, Heidbuchel H, Van De Werf F, et al.: Long-term follow-up results of tilt training therapy in patients with recurrent neurocardiogenic syncope. Pacing Clin Electrophysiol 2002, 25: 1441-1446.
28. Kinay O, Yazici M, Nazli C, et al.: Tilt training for recurrent neurocardiogenic syncope. Jpn Heart J 2004, 45: 833-845.
29. Foglia-Manzillo G, Giada FR, Gaggioli G, et al.: Efficacy of tilt training in the treatment of neurally-mediated syncope. A randomized study. Europace 2004, 6: 199-204.
30. Dendi R, Goldstein D: Meta-analysis of nonselective versus beta-1 adrenoceptor-selective blockade in prevention of tilt-induced neurocardiogenic syncope. Am J Cardiol 2002, 89: 1319-1321.
31. Sheldon R, Connolly S, Rose S, et al.: Prevention of Syncope Trial (POST): A randomized, placebo-controlled study of metoprolol in the prevention of vasovagal syncope. Circulation 2006, 113: 1164-1170.
32. Flevari P, LiAanis EG, Theodorakis GN, et al.: Vasovagal syncope: a prospective, randomized, crossover evalaution of the effect of propranolol, nadolol and placebo on syncope recurrence and patients' well-being. J Am Coll Cardiol 2002, 40: 499-504.
33. Girolomo E, Iorio C, Sabatini P, et al.: Effects of paroxetine hydrochloride, a selective serotonin reuptake inhibitor, on refractory vasovagal syncope: A randomized, double-blind, placebo-controlled study. J Am Coll Cardiol 1999, 33: 1227-1230.
34. Theodorakis GN, Leftheriotis D, Livanis EG, et al.: Fluoxetine vs. propranolol in the treatment of vasovagal syncope: A prospective, randomized, placebo-controlled study. Europace 2006, 8: 193-198.
35. Takata TS, Wasmund SL, Smith ML, et al.: Serotonin reuptake inhibitor (Paxil) does not prevent the vasovagal reaction associated with carotid sinus massage and/or lower body negative pressure in healthy volunteers. Circulation 2002, 106: 1500-1504.
36. Salim MA, Di Sessa TG: Effectiveness of fludrocortisone and salt in preventing syncope recurrence in children: A double-blind, placebo-controlled, randomized trial. J Am Coll Cardiol 2005, 45: 484-488.
37. Qingyou Z, Junbao D, Chaoshu T: The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope. J Pediatr 2006, 149: 777-780.
38. Sud S, Massel D, Klein GJ, et al.: The expectation effect and cardiac pacing for refractory vasovagal syncope. Am J Med 2007, 120: 54-62.
39. Connolly SJ, Sheldon R, Thorpe KE, et al.: The Second Vasovagal Pacemaker Study (VPSII): A double-blind randomized controlled trial of pacemaker therapy for the prevention of syncope in patients with recurrent severe vasovagal syncope. JAMA 2003, 290: 1579-1580.
40. Raviele A, Giada F, Menozzi C, et al.: A randomized, double-blind, placebo-controlled study of permanent cardiac pacing for the treatment of recurrent tilt-induced vasovagal syncope. The vasovagal syncope and pacing trial (SYNPACE). Eur Heart J 2004, 25: 1741-1748.
41. Brignole M, Sutton R, Menozzi C, et al.: Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope. Eur Heart J 2006, 27: 1085-1092.
42. Brignole M: International study on syncope of uncertain aetiology 3 (ISSUE 3): Pacemaker therapy for patients with asystolic neurally-mediated syncope: Rationale and study design. Europace 2007, 9: 25-30.