AI Article Synopsis
- This study investigates the role of vagal activity in vasovagal syncope (VVS) by measuring heart rate (HR) deceleration capacity (DC) and deceleration runs (DRs) in patients experiencing VVS episodes.
- It involved 188 VVS patients (with some having positive head-up tilt test results) compared to 132 healthy controls, assessing their HR patterns over 24 hours.
- Results showed that VVS patients had higher HR deceleration capacity but lower minimum heart rates and longer deceleration runs compared to controls, indicating unique HR profiles in VVS patients between syncopal events.
Article Abstract
Purpose: Increased vagal activity plays a prominent role in vasovagal syncope (VVS). The aim of this study was to characterize vagal function in VVS by evaluating the heart rate (HR) deceleration capacity (DC) and the HR deceleration runs (DRs) in patients with VVS between attacks.
Methods: A total of 188 consecutive VVS patients were enrolled in the study, of whom 129 had positive head-up tilt test (HUTT); 132 healthy participants were enrolled as controls. DC, DRs (DR2, i.e., episodes of 2 consecutive beat-to-beat HR decelerations), and the sum of DR8-10 (very long DR [VLDR]) were calculated using 24-h electrograms. Clinical characteristics, DC, and DRs were compared among syncope groups and controls.
Results: Patients with VVS had higher DC (10.63 ± 2.1 vs. 6.58 ± 1.7 ms; P < 0.001) and lower minimum HR and DR6-10 than controls. No significant differences in DC or DR6-10 were found between the patients with positive and those with negative HUTT results. In multivariate logistic regression analysis, minimum HR ≥ 40 bpm (odds ratio [OR] 0.408, 95% confidence interval [CI] 0.167-0.989; P = 0.048), daytime DC ≥ 7.37 ms (OR 3.040, 95% CI 1.220-7.576; P = 0.013), and VLDR ≥ 0.046% (OR 0.306, 95% CI 0.138-0.679; P = 0.004) were demonstrated to be risk factors significantly associated with VVS.
Conclusion: Compared to healthy controls, patients with VVS demonstrated distinct HR deceleration profiles between attacks, including overall higher DC and lower DR6-10.
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| http://dx.doi.org/10.1007/s10286-023-00989-z | DOI Listing |
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