The value of electrophysiologic studies in syncope of undetermined origin: Report of 150 cases

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…In this setting, a structured ED protocol can be effective as an alternative to inpatient admission. [107][108][109][110] Decision support algorithms may reduce health service use in the evaluation of syncope (Figures 1 and 2), 105,[111][112][113] although there are currently insufficient data to advocate the use of specific decision support algorithms for making disposition decisions.…”

“…109,679,680 Although some of the risk is attributable to the aspects of syncope described in this guideline, among older adults such risks are usually compounded by multiple morbidities and frailty, which add to age-related vulnerability to syncope, 671,681,682 and by the physical injuries associated with falls, collisions, or trauma, which more commonly result from syncope in old age. 670 Furthermore, recurrent syncope can lead to nursing home admission and a devastating loss of independence.…”

Epidemiology of reflex syncope

“…Cardiac causes become even more prominent when looking at data from specialized cardiac syncope units. Several studies reported that 45 to 80 % of unexplained syncope in this setting could be assigned to a cardiac cause [28,36,41,55].…”

Electrophysiologic Study and Ergonovine Provocation of Coronary Spasm in Unexplained Syncope.

“…Keeping in mind that in some cases the syncope may be a prodrome of sudden death, these patients should undergo proper diagnosis and therapy including EPS and ergonovine CAG, as well as observation of clinical symptoms.l3), 15) …”