| Mechanism of syncope in patients with isolated syncope and in patients with tilt-positive syncope. | |
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MedLine Citation:
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PMID: 11551877 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Because of its episodic behavior, the correlation of spontaneous syncope with an abnormal finding can be considered a reference standard. METHODS AND RESULTS: We inserted an implantable loop recorder in 111 patients with syncope, absence of significant structural heart disease, and a normal ECG; tilt-testing was negative in 82 (isolated syncope) and positive in 29 (tilt-positive). The patients had had >/=3 episodes of syncope in the previous 2 years and were followed up for 3 to 15 months. Results were similar in the isolated syncope group and the tilt-positive group: syncope recurred in 28 (34%) and 10 patients (34%), respectively, and electrocardiographic correlation was found in 24 (23%) and 8 (28%) patients, respectively. The most frequent finding, which was recorded in 46% and 62% of patients, respectively, was one or more prolonged asystolic pauses, mainly due to sinus arrest, preceded for a few minutes by progressive bradycardia or progressive tachycardia-bradycardia. Bradycardia without pauses was observed in 8% and 12% of cases, respectively. The remaining patients had normal sinus rhythm or sinus tachycardia, except for one, who had ectopic atrial tachycardia. In the tilt-positive group, an asystolic syncope was also recorded when the type of response to tilt-testing was vasodepressor or mixed. Presyncopal episodes were never characterized by asystolic pauses; normal sinus rhythm was the most frequent finding. CONCLUSIONS: Homogeneous findings were observed during syncope. In most patients, the likely cause was neurally-mediated, and the most frequent mechanism was a bradycardic reflex. In the other cases, a normal sinus rhythm was frequently recorded. Presyncope was not an accurate surrogate for syncope in establishing a diagnosis. |
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Authors:
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A Moya; M Brignole; C Menozzi; R Garcia-Civera; S Tognarini; L Mont; G Botto; F Giada; D Cornacchia; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 104 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2001 Sep |
Date Detail:
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Created Date: 2001-09-11 Completed Date: 2001-10-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1261-7 Citation Subset: AIM; IM |
Affiliation:
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Departments of Cardiology of Hospital Vall d'Hebron, Barcelona, Spain. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Bradycardia / physiopathology Cardiac Pacing, Artificial Electrocardiography Female Humans Male Middle Aged Recurrence Syncope / physiopathology*, therapy Tachycardia / physiopathology Tilt-Table Test* |
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