Neurocardiogenic Syncope

Abstract

11 systematic reviews, 41 prospective studies, 8 case-control studies, 41 cross sectional surveys, 6 qualitative studies, and 17 other designs (such as economic analyses or case reports). The average hit count for the papers in the first week after publication was 685 (SD 410; 25th, 50th, and 75th centiles 437, 578, and 795 respectively; range 175 to 3181); the average number of citations in the five years after publication was 32.5 (SD 37.5; 25th, 50th, and 75th centiles 9.5, 22, and 42.5 respectively; range 0 to 291). Only one paper was never cited. The hit count was associated with the number of subsequent citations (Pearson correlation coefficient: 0.50, P < 0.001). The result was similar for logarithms of the counts (r = 0.54, P < 0.001) (figure). For every 100 additional hits, 4.4 additional citations (95% confidence interval 3.1 to 5.7) accrued over the five years. The average hit count for randomised trials or systematic reviews was 832, for prospective or casecontrol studies was 747, and for cross sectional, qualitative, and other studies was 545 hits (P = 0.001). Longer papers attracted more hits than short papers (an extra 54.4 hits per page, P = 0.004), but this association became non-significant after adjustment for study design. Citations were predicted by paper length (an extra 9.3 citations per page, P < 0.001) and study design (randomised trials and systematic reviews yielded 46.0 citations, prospective and case-control studies 38.9 citations, and other designs 19.3 citations (P = 0.001). When the hit count was included as predictor, however, the effect of study design became non-significant; only page length (an extra 7.3 citations per page, P < 0.001) and the hit counts (an extra 3.7 citations per 100 hits, P < 0.001) remained as independent predictors. These variables explained 33% of variance in citation counts.

Neurocardiogenic Syncope and Related Disorders of Orthostatic Intolerance

“…Neurocardiogenic syncope (NCS) can be quite varied in presentation. 11 It tends to occur in younger patients and tends to exhibit 3 distinct phases that consist of a distinct prodrome (usually lightheadedness, nausea, diaphoresis, or visual changes) followed by a sudden loss of consciousness. Recovery is usually quite rapid, and postictal states are rare.…”

“…39 There are other tests of autonomic function available that provide useful information in selected patients, the details of which are available elsewhere. 11,38 Briefly, however, some aspects of tilt-table testing will be outlined. Tilt-table testing is based on the concept that an orthostatic stress, such as prolonged upright posture, could be used to cause venous pooling and thereby provoke the previously discussed responses in predisposed individuals.…”

Implantable Cardiac Monitors: Evolution Through Disruption

“…Recognizing and treating arrhythmias as the cause of syncope has clear value. 2,3 Similarly, patients with suspected atrial or ventricular arrhythmias based on symptoms might be evaluated with event monitoring to determine arrhythmia type, duration, initiation, and termination. Clinical correlation with patient symptoms to the arrhythmia is critical for making an accurate diagnosis.…”

Etiologic Considerations in the Patient With Syncope and an Apparently Normal Heart

“…In Europe, syncope that occurs with little or no prodrome is referred to as "malignant," while in North America, this term is usually used to describe vasovagal syncope associated with long asystolic pauses. 1 Recurrent syncope places a tremendous burden on patients and their families and can create significant functional impairment. The syncopal spell can have devastating results, with between 17% and 35% of patients having significant injuries.…”