| Isometric arm counter-pressure maneuvers to abort impending vasovagal syncope. | |
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MedLine Citation:
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PMID: 12475469 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We hypothesized that isometric arm exercises were able to increase blood pressure (BP) during the phase of impending vasovagal syncope and allow the patient to avoid losing consciousness. BACKGROUND: Hypotension is always present during the prodromal phase of vasovagal syncope. METHODS: We evaluated the effect of handgrip (HG) and arm-tensing in 19 patients affected by tilt-induced vasovagal syncope. The study consisted of an acute single-blind, placebo-controlled, randomized, cross-over tilt-table efficacy study and a clinical follow-up feasibility study. RESULTS: In the acute tilt study, HG was administered for 2 min, starting at the time of onset of symptoms of impending syncope. In the active arm, HG caused an increase in systolic blood pressure (SBP) from 92 +/- 10 mm Hg to 105 +/- 38 mm Hg, whereas in the placebo arm SBP decreased from 91 +/- 11 mm Hg to 73 +/- 21 mm Hg (p = 0.008). Heart rate behavior was similar in the two arms. In the active arm, 63% of patients became asymptomatic, versus 11% in the control arm (p = 0.02); conversely, only 5% of patients developed syncope, versus 47% in the control arm (p = 0.01). The patients were trained to self-administer arm-tensing treatment as soon as symptoms of impending syncope occurred. During 9 +/- 3 months of follow-up, the treatment was actually performed in 95/97 episodes of impending syncope (98%) and was successful in 94/95 (99%). No patients suffered injury or other adverse morbidity related to the relapses. CONCLUSIONS: Isometric arm contraction is able to abort impending vasovagal syncope by increasing systemic BP. Arm counter-pressure maneuvers can be proposed as a new, feasible, safe, and well accepted first-line treatment for vasovagal syncope. |
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Authors:
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Michele Brignole; Francesco Croci; Carlo Menozzi; Alberto Solano; Paolo Donateo; Daniele Oddone; Enrico Puggioni; Gino Lolli |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 40 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2002-12-11 Completed Date: 2003-01-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2053-9 Citation Subset: AIM; IM |
Affiliation:
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Arrhythmologic Centre, Department of Cardiology, Ospedali del Tigullio, Lavagna, Italy. mbrignole@ASL4.liguria.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Arm / blood supply*, physiology* Blood Pressure / physiology* Diastole / physiology Electric Impedance Electrophysiologic Techniques, Cardiac Exercise Test Feasibility Studies Female Follow-Up Studies Hand Strength / physiology Heart Rate / physiology Humans Isometric Contraction / physiology* Male Middle Aged Patient Satisfaction Reproducibility of Results Syncope, Vasovagal / physiopathology* Systole / physiology Tilt-Table Test |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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