Vasovagal syncope.
Conditions
Interventions
Physical counterpressure manoeuvres.
Sponsors
Academisch Medisch Centrum
Eligibility
Inclusion criteria
Inclusion criteria: 1. Clinical diagnosis of classical neurally-mediated reflex syncope, based on the medical history ór non-classical diagnosis of neurally-mediated reflex syncope and a positive tilt-table test. 2. 3 syncope episodes in the last 2 years ór at least 1 syncopal spell in the last year and at least 3 episodes of presyncope in the last year; 3. Recognizable prodromal symptoms; 4. Age 16-70 years.
Exclusion criteria
Exclusion criteria: 1. Suspected or certain heart disease and high likelihood of cardiac syncope: a. Syncope preceded by palpitations or precordial pain; b. Syncope during exercise; c. Heart failure; d. Ejection fraction < 40%; e. Old or recent myocardial infarction; f. Hypertrophic cardiomyopathy; g. Dilated cardiomyopathy; h. Significant valvular disease; i. Sinus bradycardia < 50 bpm or sino-atrial blocks; j. Mobitz I second degree atrioventricular block; k. Mobitz II 2nd or 3rd degree atrioventricular block; l. Complete bundle branch block; m. Rapid paroxysmal supraventricular tachycardia or ventricular tachycardia; n. Pre-excited QRS complexes; o. Prolonged QT interval; p. Right bundle branch block pattern with ST-elevation in leads V1-V3 (Brugada syndrome); q. Negative T waves in right precordial leads, epsilon waves and ventricular late potentials suggestive of arrhythmogenic right ventricular dysplasia). 2. Orthostatic hypotension; 3. Episodes of loss of consciousness different from syncope (e.g. epilepsy, psychiatric, metabolic, drop-attack, TIA, intoxication, cataplexy); 4. Steal syndrome; 5. Psychologically or physically (due to any other illness) or cognitively unfit for participation in the study according to the opinion of the investigator; 6. Patient compliance doubtful; 7. Patient geographically or otherwise inaccessible for follow-up; 8. Patient unwilling or unable to give informed consent; 9. Pregnancy; 10. Life expectancy < 1 year.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total burden of syncope recurrence (number of syncopal spells/year/patient). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Time to first recurrence; 2. Presyncope burden; 3. Quality of life. | — |
Contacts
Public ContactW. Wieling
Academic Medical Center (AMC), Department of Internal Medicine, P.O. Box 22660
Outcome results
None listed