Síncope y bloqueo de rama. Rendimiento del uso escalonado del estudio electrofisiológico y de la monitorización electrocardiográfica prolongada

Azocar, Damián; Ruiz‐Granell, Ricardo; Ferrero, Àngel; Martínez-Brotons, Ángel; Izquierdo, Maite; Domínguez, Eloy; Palau, Patricia; Morell, Salvador; García‐Civera, Roberto

doi:10.1016/j.recesp.2010.10.016

Cited by 15 publications

(1 citation statement)

References 18 publications

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“…Some subgroups of patients did not benefit from an EP study, meaning that the EP results were non-diagnostic. Identification of these patients is important so that the risk and expense of EP study could be avoided (11-13). Prognosis of syncope varies widely and 1-year mortality may range from 0% in the case of vasovagal events up to 30% in the presence of heart disease (7, 14, 15).…”

Section: Introductionmentioning

confidence: 99%

Predicting the outcome in patients with unexplained syncope and suspected cardiac cause: Role of electrophysiologic studies

Rad¹,

Farahani²,

Emkanjoo³

et al. 2015

Anatol J Cardiol

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Objective:Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies widely depending on underlying causes, specially, cardiac ones. We sought to determine the abnormal electrophysiolgic (EP) study results as predictors of prognosis in syncope patients with suspected cardiac cause and risk factors associated with mortality.Methods:A total of 227 consecutive patients with unexplained syncope were prospectively enrolled in this study. EP study was performed in 177 patients in base of inclusion criteria. These patients, in whom a cardiac cause of syncope was suspected, underwent EP study and if negative, head-up tilts test (HUTT). Complete follow-up was obtained for 132 patients for 20.0±10.8 months.Results:A cardiac cause of syncope was established in 35%, a neurally mediated syncope in 35.6%, and in the rest 29.4% the cause of syncope remained unexplained despite a throughout neurologic and cardiologic evaluation. Logistic analysis revealed that the significant predictors of a cardiac cause of syncope were the absence of prodromal symptoms, left bundle branch block (LBBB), sever left ventricle (LV) dysfunction and male gender. At logistic analysis, the presence of LBBB (OR=6.63; 95% CI: 1.09-40) was significantly associated with outcome of death.Conclusion:The present study provides evidence that presence of LBBB, abnormal EP study result and structural heart disease (SHD) have prognostic value in patients with suspected cardiac cause of syncope. The patients with SHD and unexplained syncope who had a negative EP study have a good long-term prognosis even in the presence of LV dysfunction.

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