Diagnosis of neurally mediated syncope at initial evaluation and with tilt table testing compared with that revealed by prolonged ECG monitoring: An analysis from the third international study on syncope of uncertain etiology (ISSUE-3)

Heart

Volumn 99, Issue 24, 2013, Pages 1825-1831

  Ungar, Andrea ^a   Sgobino, Paolo ^b   Russo, Vitantonio ^c   Vitale, Elena ^d   Sutton, Richard ^e   Melissano, Donato ^f   Beiras, Xulio ^g   Bottoni, Nicola ^f   Ebert, Hans H ^f   Gulizia, Michele ^h   Jorfida, Marcella ⁱ   Moya, Angel ^j   Andresen, Dietrich ^k   Grovale, Nicoletta ^f   Brignole, Michele ^l  

^a CAREGGI UNIVERSITY HOSPITAL   (Italy)

^b Ospedale di Bolzano   (Italy)

^c Department of Cardiology   (Italy)

^d C Arrigo Children's Hospital   (Italy)

^e IMPERIAL COLLEGE HEALTHCARE NHS TRUST   (United Kingdom)

^f Presidio Ospedaliero di Casarano ^*  (Italy)

^g HOSPITAL XERAL CALDE   (Spain)

^h GARIBALDI HOSPITAL   (Italy)

ⁱ MOLINETTE HOSPITAL   (Italy)

^j HOSPITAL UNIVERSITARI VALL D HEBRON   (Spain)

^k VIVANTES KLINIKUM AM URBAN   (Germany)

^l DEPARTMENT OF CARDIOLOGY   (Italy)

more..

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; BRADYCARDIA; CANADA; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DIAGNOSTIC VALUE; ELECTROCARDIOGRAM; EUROPE; FAINTNESS; FEMALE; FOLLOW UP; HEART ARRHYTHMIA; HEART VENTRICLE TACHYCARDIA; HUMAN; IMPLANTABLE LOOP RECORDER DOCUMENTATION; INTERMETHOD COMPARISON; MAJOR CLINICAL STUDY; MALE; MEDICAL DOCUMENTATION; MULTICENTER STUDY; NEURALLY MEDIATED SYNCOPE; OBSERVATIONAL STUDY; ORTHOSTATIC HYPOTENSION; PRIORITY JOURNAL; PROSPECTIVE STUDY; TACHYCARDIA; TILT TABLE TEST; UNCONSCIOUSNESS;

AUTONOMIC NERVOUS SYSTEM;

AGED; CARDIAC PACING, ARTIFICIAL; DIAGNOSIS, DIFFERENTIAL; ELECTROCARDIOGRAPHY, AMBULATORY; FEMALE; HEART CONDUCTION SYSTEM; HUMANS; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; SYNCOPE; TILT-TABLE TEST;

EID: 84888062325     PISSN: 13556037     EISSN: 1468201X     Source Type: Journal    
DOI: 10.1136/heartjnl-2013-304399     Document Type: Article

References (28)

1. Brignole M, Alboni P, Benditt DG, et al. Guidelines on management (diagnosis and treatment) of syncope-update 2004. Europace 2004;6:467-537.
2. Moya A, Sutton R, Ammirati F, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009;30:2631-71.
3. Sheldon R. Tilt table testing and implantable loop recorders for syncope. Cardiol Clin 2013;31:67-74.
4. Bartoletti A, Alboni P, Ammirati F, et al. The Italian protocol: a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope. Europace 2000;2:339-42.
5. Brignole M, Menozzi C, Del Rosso A, et al. New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Europace 2000;2:66-76.
6. Brignole M, Moya A, Menozzi C, et al. Proposed electrocardiographic classification of spontaneous syncope documented by an implantable loop recorder. Europace 2005;7:14-18.
7. The Steering Committee of the ISSUE 3 Study. 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.
8. Brignole M, Menozzi C, Moya A, et al. Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial. Circulation 2012;125:2566-71.
9. Galizia G, Abete P, Mussi C, et al. Role of early symptoms in assessment of syncope in elderly people: results from the Italian group for the study of syncope in the elderly. J Am Geriatr Soc 2009;57:18-23.
10. Del Rosso A, Alboni P, Brignole M, et al. Relation of clinical presentation of syncope to the age of patients. Am J Cardiol 2005;96:1431-5.
11. Sun BC, Hoffman JR, Mangione CM, et al. Older age predicts short-term, serious events after syncope. J Am Geriatr Soc 2007;55:907-12.
12. Brignole M, Deharo JC, De Roy L, et al. Syncope due to idiopathic paroxysmal atrioventricular block: long-term follow-up of a distinct form of atrioventricular block. J Am Coll Cardiol 2011;58:167-73.
13. Flammang D, Church TR, De Roy L, et al. Treatment of unexplained syncope: a multicenter, randomized trial of cardiac pacing guided by adenosine 5′-triphosphate testing. Circulation 2012;125:31-6.
14. Leitch JW, Klein GJ, Yee R, et al. Syncope associated with supraventricular tachycardia: an expression of tachycardia or vasomotor response? Circulation 1992;85:1064-71.
15. Brignole M, Gianfranchi L, Menozzi C, et al. Role of autonomic reflexes in syncope associated with paroxysmal atrial fibrillation. J Am Coll Cardiol 1993;22:1123-9.
16. Kapoor WN, Karpf M, Wleand S, et al. A prospective evaluation and follow-up of patients with syncope. N Engl J Med 1983;309:197-204.
17. Sarasin FP, Louis-Simonet M, Carballo D, et al. Prospective evaluation of patients with syncope: a population-based study. Am J Med 2001;111:177-84.
18. Alboni P, Brignole M, Menozzi C, et al. Diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol 2001;37:1921-8.
19. Sheldon R, Rose S, Connolly S, et al. Diagnostic criteria for vasovagal syncope based on a quantitative history. Eur Heart J 2006;27:344-50.
20. van Dijk N, Boer KR, Colman N, et al. High diagnostic yield and accuracy of history, physical examination, and ECG in patients with transient loss of consciousness in FAST: the fainting assessment study. J Cardiovasc Electrophysiol 2008;19:48-55.
21. Sheldon R, Rose S, Koshman ML. Comparison of patients with syncope of unknown cause having negative or positive tilt-table tests. Am J Cardiol 1997;80:581-5.
22. Grimm W, Degenhardt M, Hoffman J, et al. Syncope recurrence can better be predicted by history than by head-up tilt testing in untreated patients with suspected neurally mediated syncope. Eur Heart J 1997;18:1465-9.
23. Moya A, Brignole M, Menozzi C, et al. Mechanism of syncope in patients with isolated syncope and in patients with tilt-positive syncope. Circulation 2001;104:1261-7.
24. Brignole M, Sutton R, Menozzi C, et al. Lack of correlation between the responses to tilt testing and adenosine triphosphate test and the mechanism of spontaneous neurally mediated syncope. Eur Heart J 2006;27:2232-9.
25. Sud S, Klein G, Skanes A, et al. Implications of mechanism of bradycardia on response to pacing in patients with unexplained syncope. Europace 2007;9:312-18.
26. 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;27:1085-92.
27. Edvardsson N, Frykman V, van Mechelen R, et al. PICTURE study investigators. Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry. Europace 2011;13:262-9.
28. Furukawa T, Maggi R, Bertolone C, et al. Additional diagnostic value of very prolonged observation by implantable loop recorder in patients with unexplained syncope. J Cardiovasc Electrophysiol 2012;23:67-71.