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. 2010 Oct 26;2(10):308-15.
doi: 10.4330/wjc.v2.i10.308.

Management and therapy of vasovagal syncope: A review

Muhammet Ali Aydin  1 , Tushar V Salukhe, Iris Wilke, Stephan Willems
Affiliations

Management and therapy of vasovagal syncope: A review

Muhammet Ali Aydin et al. World J Cardiol. .

Abstract

Vasovagal syncope is a common cause of recurrent syncope. Clinically, these episodes may present as an isolated event with an identifiable trigger, or manifest as a cluster of recurrent episodes warranting intensive evaluation. The mechanism of vasovagal syncope is incompletely understood. Diagnostic tools such as implantable loop recorders may facilitate the identification of patients with arrhythmia mimicking benign vasovagal syncope. This review focuses on the management of vasovagal syncope and discusses the non-pharmacological and pharmacological treatment options, especially the use of midodrine and selective serotonin reuptake inhibitors. The role of cardiac pacing may be meaningful for a subgroup of patients who manifest severe bradycardia or asystole but this still remains controversial.

Keywords: Adrenergic β-antagonists; Midodrine; Serotonin uptake inhibitors; Vasovagal syncope.

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Figures

Figure 1
Figure 1
Classification of syncope.
Figure 2
Figure 2
Diagnostic pathway in syncope. 1Structural heart disease (e.g. valvular, myocardial infarction) or vascular diseases (e.g. pulmonary embolism, aortic disease). ECG: Electrocardiography; RR: Non-invasive blood-pressure; TTE: Transthoracic echocardiography; EP: Electrophysiologic study; ILR: Implantable loop recorder; TT: Head-up tilt table test.
Figure 3
Figure 3
Treatment of vasovagal syncope. SSRI: Selective serotonin reuptake inhibitors.
See this image and copyright information in PMC

References

    1. Savage DD, Corwin L, McGee DL, Kannel WB, Wolf PA. Epidemiologic features of isolated syncope: the Framingham Study. Stroke. 1985;16:626–629. - PubMed
    1. Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, Deharo JC, Gajek J, Gjesdal K, Krahn A, et al. Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC) Eur Heart J. 2009;30:2631–2671. - PMC - PubMed
    1. Aydin MA, Maas R, Mortensen K, Steinig T, Klemm H, Risius T, Meinertz T, Willems S, Morillo CA, Ventura R. Predicting recurrence of vasovagal syncope: a simple risk score for the clinical routine. J Cardiovasc Electrophysiol. 2009;20:416–421. - PubMed
    1. Brignole M, Menozzi C, Del Rosso A, Costa S, Gaggioli G, Bottoni N, Bartoli P, Sutton R. New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Vasovagal Syncope International Study. Europace. 2000;2:66–76. - PubMed
    1. Ganzeboom KS, Colman N, Reitsma JB, Shen WK, Wieling W. Prevalence and triggers of syncope in medical students. Am J Cardiol. 2003;91:1006–1008, A8. - PubMed