Syncope unit: Experience of a center using diagnostic flowcharts for syncope of uncertain etiology after initial assessment

Clinical history in management of suspected syncope: A powerful diagnostic tool

“…Syncope units have begun to be organized in the last 10 years. The diagnostic yield of patients presenting to these units is high (85-95%) [13][14][15][16][17][18][19][20][21]. Table 1 shows rates of diagnoses for various syncope units.…”

Financial impact of adopting implantable loop recorder diagnostic for unexplained syncope compared with conventional diagnostic pathway in Portugal

“…Sousa and colleagues report data from a syncope unit in the south of Portugal, and although it refers specifically to Portuguese practice in syncope management, it is a very unique case in the country and therefore may not reflect the national reality [24]. Nevertheless, taking into account the very low incidence of ILR implants in our country, a possible deviation is for having a higher number and more diverse type of investigations in Portugal, which would actually underestimate the expenditure with investigations, leading to a more favourable cost profile for ILR.…”

“…In order to provide an estimation of the average cost of a syncope episode admission, we have considered five scenarios, using data on the frequency of a range of diagnostic rests from the various studies recently published on syncope management (Sousa Pedro [ 24 ] Edvardsson [ 21 ]; Baron-Esquiviais [ 7 ]; Brignole [ 4 ]; Farwell [ 16 ]) to which we applied the unit costs/prices published by the Portuguese National Health Service prices table [ 25 ]. Using a conservative approach, we decided to exclude from the analysis the exams for which Portuguese unitary costs were not available.…”

“…Using a conservative approach, we decided to exclude from the analysis the exams for which Portuguese unitary costs were not available. The average diagnostic cost per syncope was determined to be between 72.41€ and 1,112.02€ (see details in Table 1 ); in the base-case analysis, a diagnostic cost of 164.32€ was applied (based on Sousa Pedro [ 24 ]) to all syncope events in the CDP arm (regardless of whether a successful diagnosis was made), and to syncope events occurring in the ILR arm beyond the 3-year device battery life.…”

Syncope Unit: rationale and requirement – the European Heart Rhythm Association position statement endorsed by the Heart Rhythm Society

“…Disorders causing T-LOC are diverse and are reported to occur at different rates illustrtaing the scope of the necessary competencies. Results of 10 SUs 13,17,19,23,41,45,55,56 (W. Wieling and J.G. van Dijk, personal communication) yielded the following categories (mean and range): reflex syncope (59%, 46 -68), cardiac (10%, 1 -35), orthostatic hypotension (9%, 1 -19), unexplained syncope (11%, 5 -18), psychogenic pseudosyncope (4%, 0 -12), and epileptic seizures (1%, 0 -5).…”