The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome
Abstract
It is generally accepted that a positive response to carotid sinus massage (CSM) or head-up tilt (HUT) in patients affected by syncope suggests a reflex cause of the syncope. To study the role of the autonomic nervous system in causing syncope in the sick sinus syndrome (SSS), CSM and HUT were performed in 35 consecutive patients (20 men, mean age 70 +/- 9 years) with syncope and SSS. Results were compared with those in 35 patients affected by syncope that, despite careful cardiovascular and neurologic examination, were of uncertain origin (21 men; mean age 68 +/- 9 years) and with those of 35 subjects without syncope (20 men; mean age 69 +/- 10). All patients underwent CSM in the supine and standing positions for 10 seconds and HUT to 60 degrees for 60 minutes. In the patients with SSS, the full reproduction of spontaneous symptoms by CSM occurred in 21 (60%) and by HUT, in 19 (54%). At least 1 test was positive in 28 patients (80%): cardioinhibitory or mixed responses in 69%, vasodepressor responses in 11%. The percentages of positive tests in the patients with syncope of uncertain origin were similar to or slightly less than those of patients with SSS (CSM 63%, HUT 26%, overall 74%) with cardioinhibitory or mixed responses in 54% and vasodepressor in 20% (p less than 0.05). In control subjects, syncope was induced by CSM in 1 (3%) and by HUT in 2 (6%); overall positivity was 9%. In conclusion, in most patients affected by syncope and SSS, an abnormal neural reflex probably plays a major role in causing syncope.(ABSTRACT TRUNCATED AT 250 WORDS)
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“Similarly, multifactorial mechanisms are likely in other types of cardiac syncope, e.g. aortic stenosis, 133 hypertrophic cardiomyopathy (HCM), 134 and sick sinus syndrome. 135,136”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [135]
In the citing paper
“Thus, an increased susceptibility to neurally mediated bradycardia/ hypotension is often the cause of syncope. 135,136”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [135]
Citations
Cites
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A Prospective Evaluation and Follow-up of Patients with Syncope
Kapoor, W. N., Karpf, M., Wieand, S., Peterson, J. R., & Levey, G. S. (1983) · New England Journal of Medicine · doi:10.1056/nejm198307283090401 · Cited by 779
HEAD-UP TILT: A USEFUL TEST FOR INVESTIGATING UNEXPLAINED SYNCOPE
Kenny, R. A., Bayliss, J. M., Ingram, A., & Sutton, R. (1986) · The Lancet · doi:10.1016/s0140-6736(86)91665-x · Cited by 777
The normal range and determinants of the intrinsic heart rate in man
Jose, A. D., & Collison, D. (1970) · Cardiovascular Research · doi:10.1093/cvr/4.2.160 · Cited by 585
Methodology of head-up tilt testing in patients with unexplained syncope
Fitzpatrick, A. P., THEODORAKIS, G. N., Vardas, P. E., & Sutton, R. (1991) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(91)90714-k · Cited by 428
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TILTING TOWARDS A DIAGNOSIS IN RECURRENT UNEXPLAINED SYNCOPE
Fitzpatrick, A. P., & Sutton, R. (1989) · The Lancet · doi:10.1016/s0140-6736(89)92155-7 · Cited by 254
Semi-security and psychiatric hospitals.
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Diagnostic efficacy of 24-hour electrocardiographic monitoring for syncope
Gibson, T. C., & Heitzman, M. (1984) · The American Journal of Cardiology · doi:10.1016/0002-9149(84)90628-3 · Cited by 224
Kapoor, W. N., Snustad, D. G., Peterson, J. R., Wieand, H. S., Cha, R., & Karpf, M. (1986) · The American Journal of Medicine · doi:10.1016/0002-9343(86)90716-3 · Cited by 202
Research works printed but not linked: 1
- Kaseda, 1988, Vagal denervation of canine sinus and atrioventricular nodes creates supersensitive response to acetylcholine (abstr), J Am Coll Cardiol, 11, 39A
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ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities
Epstein, A. E., DiMarco, J. P., Ellenbogen, K. A., Estes, N. A. M., Freedman, R. A., Gettes, L. S., Gillinov, A. M., Gregoratos, G., Hammill, S. C., Hayes, D. L., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.02.032 · Cited by 2,546
Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040
2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab364 · Cited by 2,019
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities
Epstein, A. E., Dimarco, J., Ellenbogen, K. A., Estes, N. A. M., Freedman, R. A., Gettes, L. S., Gillinov, A. M., Gregoratos, G., Hammill, S. C., Hayes, D. L., et al. (2008) · Circulation · doi:10.1161/circualtionaha.108.189742 · Cited by 1,772
Metadata
- Authors
- Brignole, M., Menozzi, C., Gianfranchi, L., Oddone, D., Lolli, G., & Bertulla, A.
- Affiliations
- Presidio Ospedaliero (IT)
- ORCID
- Brignole, Michele
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1991-10
- Volume
- 68
- Issue
- 10
- Pages
- 1032-1036
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2127225262
- Cited by
- 132
- References
- 22
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 5 · 2016: 2 · 2014: 2 · 2013: 5 · 2012: 6
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- syncope, sick sinus syndrome, carotid sinus massage, head-up tilt, neurogenic syncope, autonomic nervous system, cardioinhibitory response, vasodepressor response, neural reflexes
- MeSH terms
- Aged, Autonomic Nervous System, Carotid Sinus, Female, Humans, Male, Posture, Reflex, Sick Sinus Syndrome, Syncope
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