Evidence-based treatment for vasovagal syncope

Kuriachan, Vikas; Sheldon, Robert S.; Platonov, Michael

doi:10.1016/j.hrthm.2008.08.023

Cited by 43 publications

(24 citation statements)

References 24 publications

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“…While the former might be beneficial, the latter is not. 114 Most of the studies on tilt-training were poorly controlled. This treatment is hampered by poor patient compliance when conducting the program for an extended period of time and by an as yet undetermined biologic mechanism.…”

Section: Section 3: Vasovagal Syncope Definitionmentioning

confidence: 99%

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

et al. 2015

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Section: Section 3: Vasovagal Syncope Definitionmentioning

confidence: 99%

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

et al. 2015

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“…When necessary, physical countermeasures (muscle tensing, leg crossing) are harmless, freeof-charge, evidence-based methods of treatment (Kuriachan et al, 2008).…”

Section: Managementmentioning

confidence: 99%

Syncopes and other paroxysmal events

Stephenson

2013

Pediatric Neurology Part II

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“…One of the earliest treatments to be attempted was β-receptor blockade. 1 After initial enthusiasm, [2][3][4] this treatment was questioned 5,6 and subjected to at least 5 randomized clinical trials, with syncope as the primary outcome. 4,[7][8][9][10] They culminated in little evidence for the effectiveness of β-blockers in preventing vasovagal syncope in the general population.…”

mentioning

confidence: 99%

Age-Dependent Effect of β-Blockers in Preventing Vasovagal Syncope

Sheldon

Morillo

Klingenheben

et al. 2012

Circ: Arrhythmia and Electrophysiology

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Background-β-blockers have little effectiveness in preventing vasovagal syncope in unselected populations, but they might be effective in older patients. We determined whether β-blockers prevent vasovagal syncope in an age-related fashion. Methods and Results-Two populations were studied. A proportional hazards analysis was performed on an observational cohort study of 153 patients with vasovagal syncope, 52 of whom received β-blockers. A multivariable proportional hazards model stratified by center was performed on 208 participants in the randomized Prevention of Syncope Trial (POST), examining the interaction between age group and treatment with metoprolol. Age-specific hazard ratios were estimated for both studies and combined using the inverse variance meta-analytic method. In the cohort study, the hazard ratio for syncope if treated with β-blockers was 1.54 (95% CI, 0.78-3.05) for patients aged <42 years and 0.48 (95% CI, 0.12-1.92) for patients aged ≥42 years. In POST, the proportional hazards model showed interactions between age and treatment effect (P=0.026). The hazard ratio for patients aged ≥42 years who received metoprolol was 0.53 (95% CI, 0.25-1.10); in patients aged <42 years, the hazard ratio was 1.62 (95% CI, 0.85-3.10). A pooled analysis of both studies yielded an estimate of the hazard ratio of 1.58 (CI, 1.00-2.31) for patients aged <42 years, and the hazard ratio was 0.52 (CI, 0.27-1.01) for patients aged ≥42 years. The 2 age groups differed significantly in response to β-blockers (P=0.007). Conclusions-β-blocker

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Evidence-based treatment for vasovagal syncope

Cited by 43 publications

References 24 publications

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

Syncopes and other paroxysmal events

Age-Dependent Effect of β-Blockers in Preventing Vasovagal Syncope

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