Background: There is no universally followed protocol for managing Reflex Vasovagal syncope (VVS).
Methods: VVS patients were treated with a 2 step protocol. Step I - counseling, hydration, physiotherapy, and Tadasana Yoga maneuver. Patients with ≥2 VVS recurrences were given step II care - intensification of step I, elastic stockings,and pharmacotherapy. Follow-up included assessment by periodic functional status questionnaires.
Results: 157 patients (103 males & 54 females,mean age - 53 ± 20 years & mean LVEF - 62 ± 5%.) experienced 867 total events - 382 syncopal, and 485 near syncopal episodes over 14 ± 9 months. After step I protocol, the mean total, syncopal and near syncopal events declined from 5 ± 7 to 0.3 ± 1.2 (P < 0.0001), 3 ± 2 to 0.1 ± 0.4 (P < 0.0001) and 3 ± 6 to 0.2 ± 1.1 (P < 0.0001) respectively. Twenty (12.7%) patients had 53 event recurrences, 15- syncopal episodes in 7 and 38 near syncope events in 13. After step II, 5 patients had 14 events. At 33 ± 15 months, in 152 patients (96.8%) there were no recurrences and syncope was prevented in all (100%). The median total, syncopal and near syncopal events declined from 3 to 0,(p < 0.001) 2 to 0 (p < 0.001) and 1 to 0 (p < 0.001) respectively. There was an improvement in all the 3 quality of life parameters.
Conclusion: We demonstrate a simple and effective protocol that can be universally adopted to prevent VVS recurrences,with improvement in quality of life.
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http://dx.doi.org/10.1016/j.ijcard.2024.132302 | DOI Listing |
Cardiol Res
December 2024
Biostatistics, Epidemiology, and Scientific Computing Department, King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia.
Background: Syncope is a common medical condition. The reflex or neurally mediated syncope (NMS) is the most frequent type. The tilt table test (TTT) helps distinguish syncope from other common causes of complete loss of consciousness, such as epilepsy, define syncope subtypes and guide management.
View Article and Find Full Text PDFJ Interv Card Electrophysiol
December 2024
Arrhythmia Department, Teknon Heart Institute, Teknon Medical Center, Barcelona, Spain.
Background: Cardioneuroablation (CNA) treats reflex syncope by ablating ganglionated plexi (GPs) either confined to the right (RA) or left atrium (LA), or accessible from both. We assessed whether GP ablation in one atrium affects parasympathetic modulation in the other and how ablation sequence (RA then LA, or vice-versa) impacts efficacy.
Methods: Two propensity-matched groups of patients with reflex syncope or functional bradycardia were analyzed.
Neurol India
September 2024
Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India.
Background And Objectives: Dizziness is a frequent complaint encountered in neurology clinics. Dizziness can be spontaneous or triggered, which includes orthostatic dizziness. Orthostatic dizziness can be acute (reflex/vasovagal syncope), chronic (orthostatic hypotension (OH), or postural orthostatic tachycardia syndrome (POTS).
View Article and Find Full Text PDFMath Biosci
November 2024
Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Catolica de Chile, Avda.Vicuña Mackenna 4860, Macul, Santiago, 8970117, Chile; Millenium Institute for Intelligent Healthcare Engineering iHEALTH, Avda.Vicuña Mackenna 4860, Macul, Santiago, 8970117, Chile. Electronic address:
HeartRhythm Case Rep
September 2024
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
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