6533b7d5fe1ef96bd1263f64
RESEARCH PRODUCT
Reproducibility of electrocardiographic findings in patients with suspected reflex neurally-mediated syncope
M BrignoleR SuttonC MenozziA MoyaR Garcia-civeraD G BendittP VardasW WielingD AndresenR MiglioriniD HollinworthN GrovaleF ZannaM P LopezS MohammadA GuthmannM Manders D Van AggelD ErckensV AndersenE SousaniC Eppacher J St Ores T De SantoC MenozziN BottoniF AmmiratiM SantiniM BrignoleP DonateoA RevieleF GiadaS OraziP AlboniM DinelliG PeregoR Brambilla A Del RossoA Vincenti S De CegliaB SassoneM T BarattoA UngarS CurròM GuliziaM FranceseL PandolfoM BurattiniD CornacchiaE CasaliP GianiL SantangeloS Panico G De MarchiA MarchettiG BujaF FolinoA SpampinatoG BruniM LunatiG ButteraR García-civeraS MorellR RuizR SanjuanJ F Garcia-sacristanX BeirasG CamposA MoyaC AlonsoA Garcia-alberolaJ LacunaJ P VillacastínP CastellanosJ RodaV PalancaJ MartíJ DelclósM AlvarezL TercedorE CastellanosT MauriI F LozanoJ TomásJ BènèzetM FidalgoJ G MartinezB HerrerosF MuñozJ Aerts A JA Boersma L VW WielingJ M Schroeder-tanka R Van MechelenJ H RuiterD AndresenC EhlersT MeinertsA SchuchertT ViethC Reithmann P Von LowisT CrippsN SulkeR SuttonR A KennyJ D SkehanV PaulM WrigleyD G BendittP VardasG E LouridasV VasilikosT N JakobsenE H SimonsenJ B Johansen W Grander Affiliationsubject
Malemedicine.medical_specialtySocio-culturaleNeurological disorderVentricular tachycardiaElectrocardiographyInternal medicinemedicineSyncope VasovagalHumansSinus rhythmProspective Studiescardiovascular diseasesAsystoleProspective cohort studymedicine.diagnostic_testbiologybusiness.industrySyncope (genus)Reproducibility of ResultsMiddle Agedmedicine.diseasebiology.organism_classificationElectrocardiographic FindingAnesthesiaCardiologycardiovascular systemFemaleCardiology and Cardiovascular MedicinebusinessElectrocardiographydescription
The reproducibility of electrocardiographic (ECG) recordings in syncopal recurrences and the diagnostic role of nonsyncopal arrhythmias are not well known. The objective of this study was to analyse the reproducibility of the ECG findings recorded with implantable loop recorders in 41 patients with suspected neurally-mediated syncope who were included in the International Study on Syncope of Uncertain Origin-2 study and that had > or =2 events recorded by implantable loop recorders. In these patients, the electrocardiogram obtained with the first documented syncope (index syncope) was compared with other recorded events. Twenty-two patients had > or =2 syncopes, and their electrocardiograms were reproducible in 21 (95%): 15 with sinus rhythm, 5 with asystole, and 1 with ventricular tachycardia; 1 had asystole at first syncope and sinus rhythm at recurrent syncope. In 32 patients with nonsyncopal episodes, an arrhythmia was documented in 9, and all of them had the same arrhythmia during the index syncope (100% reproducibility); conversely, when sinus rhythm was documented (23 patients) during nonsyncopal episodes, an arrhythmia was still documented in 6 during the index syncope (70% reproducibility; p = 0.0004). In conclusion, the ECG findings during the first syncope are highly reproducible in subsequent syncopes. The presence of an arrhythmia during nonsyncopal episodes is also highly predictive of the mechanism of syncope, but the presence of sinus rhythm does not rule out the possibility of arrhythmia during syncope. Therefore the finding of an arrhythmia during a nonsyncopal episode allows the etiologic diagnosis of syncope, and eventually to anticipate treatment, without waiting for syncope
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2008-01-01 |