Evolução clínica de pacientes com síncope neurocardiogênica (SNC) após suspensão da terapia específica

Abstract

OBJECTIVETo evaluate the outcome of patients with NCS after interruption of pharmacological therapy and to investigate the possible clinical variables predicting recurrence. METHODSThirty-seven patients (age 31±16 years) with refractory recurrent NCS being 19 females where prospectively studied. All patients became asymptomatic and had a negative tilt table test (TT) after pharmacological therapy. The treatment was interrupted and one month later, a new TT with no medication was carried out. The probability free of symptoms recurrence was analyzed according to sex, age, number of syncope episodes previously to the treatment, clinical history time, treatment time, drug free from treatment time and TT result. RESULTSTwenty-two patients (59%) presented recurrence during a mean follow-up of 21±19.7 months. The variables related to greater recurrence were number of previous syncope (p=0.0248), positive TT after interruption of the therapy (p=0.0002) and female gender (p= 0.0131). CONCLUSIONSMost of the very symptomatic patients with NCS present recurrence after the suppression of a specifi c therapy. A TT carried out after treatment discontinuation can identify patients with higher risk of recurrence, specially in the fi rst year of follow-up.