The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
An Implantable Loop Recorder Study of Highly Symptomatic Vasovagal Patients
Open accessAbstract
Objectives The aim of this study was to analyze the heart rhythm during spontaneous vasovagal syncope (VVS) in highly symptomatic patients with implantable loop recorders (ILR) and to correlate this rhythm with the heart rhythm observed during head-up tilt test (HUT).Background Heart rhythm obtained during provocative condition is often used to guide therapy in VVS. To date there is no conclusive evidence that the heart rhythm observed during a positive HUT can predict heart rhythm during VVS or that the heart rhythm observed during a spontaneous syncope will be identical to the recurrent syncope.Methods Twenty-five consecutive VVS patients (age 60.2 +/- 17.1 years; 14 women,) presenting with frequent syncopes (6.9 +/- 4.6 episodes/year) and a positive HUT (cardioinhibitory in 8 patients) were implanted with an ILR. Seven of them also had a positive adenosine triphosphate (ATP) test.Results Follow-up was 17.0 +/- 3.6 months. Thirty VVS were observed in 12 patients. Nine episodes showed bradycardia of <40 beats/min or asystole; progressive sinus bradycardia preceding sinus arrest was the most frequent electrocardiographic finding. Twenty-one syncopes occurred without severe bradycardia. The heart rhythm observed during the first syncope was identical to the recurrence. No correlation was found between slow heart rate at the ILR interrogation and a cardioinhibitory HUT response (p = 1.0) or a positive ATP test (p = 1.0).Conclusions In highly symptomatic patients with VVS, the heart rhythm observed during spontaneous syncope does not correlate with the HUT. The heart rhythm during the first spontaneous syncope is identical to the recurrent syncope.
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“While a positive cardioinhibitory response to tilt testing predicts, with a high probability, an asystolic spontaneous syncope, the presence of a positive vasodepressor, mixed response, or even a negative response, does not exclude the presence of asystole during spontaneous syncope. 122,123”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [122]
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“A positive cardioinhibitory response to tilt testing predicts, with high probability, asystolic spontaneous syncope; this finding is relevant for therapeutic implications when cardiac pacing is considered (see section 5.2.6).”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [122]
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“While a positive cardioinhibitory response to tilt testing predicts, with a high probability, an asystolic spontaneous syncope, the presence of a positive vasodepressor, mixed response, or even a negative response, does not exclude the presence of asystole during spontaneous syncope. 122,123”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [122]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Conversely, the presence of a positive vasodepressor, a mixed response, or even a negative response does not exclude the presence of asystole during spontaneous syncope. 122,123”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [122]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“previous studies showed no correlation between AV block induced by ATP and ECG findings (documented by ILR) during spontaneous syncope. 122,123,227”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [122]
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Citations
Cites
Connolly, S. J., Sheldon, R., Thorpe, K. E., Roberts, R. S., Ellenbogen, K. A., Wilkoff, B. L., Morillo, C., Gent, M., & for the VPS II Investigators (2003) · JAMA · doi:10.1001/jama.289.17.2224 · Cited by 500
The North American vasovagal pacemaker study (VPS)
Connolly, S., Sheldon, R., Roberts, R., & Gent, M. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00549-x · Cited by 474
Sutton, R., Brignole, M., Menozzi, C., Raviele, A., Alboni, P., Giani, P., & Moya, A. (2000) · Circulation · doi:10.1161/01.cir.102.3.294 · Cited by 407
The elusive pathophysiology of neurally mediated syncope
Mosqueda-Garcia, R., Furlan, R., MD, J. T., & Fernandez-Violante, R. (2000) · Circulation · doi:10.1161/01.cir.102.23.2898 · Cited by 383
Mechanism of Syncope in Patients With Isolated Syncope and in Patients With Tilt-Positive Syncope
Moya, A., Brignole, M., Menozzi, C., Garcia-Civera, R., Tognarini, S., Mont, L., Botto, G., Giada, F., Cornacchia, D., & on behalf of the International Study on Syncope of Uncertain Etiology (ISSUE) Investigators (2001) · Circulation · doi:10.1161/hc3601.095708 · Cited by 378
Use of an Extended Monitoring Strategy in Patients With Problematic Syncope
Krahn, A. D., Klein, G. J., Yee, R., Takle-Newhouse, T., & Norris, C. (1999) · Circulation · doi:10.1161/01.cir.99.3.406 · Cited by 360
RAVIELE, A., GIADA, F., MENOZZI, C., SPECA, G., ORAZI, S., GASPARINI, G., SUTTON, R., & BRIGNOLE, M. (2004) · European Heart Journal · doi:10.1016/j.ehj.2004.06.031 · Cited by 323 · cited 1×
“This observation might be part of n explanation for the results of two recently published andomized studies on pacing therapy in vasovagal patients: n both studies, pacing therapy failed to show effectiveness, ven in the subgroup of patients presenting with severe radycardia at HUT (8,9).”
ResultAmmirati, F., Colivicchi, F., & Santini, M. (2001) · Circulation · doi:10.1161/hc2601.091708 · Cited by 299
Rose, M. S., Koshman, M. L., Spreng, S., & Sheldon, R. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00257-2 · Cited by 216
Research works printed but not linked: 1
- Brignole, 2000, Clinical features of adenosine sensitive syncope and tilt induced vasovagal syncope, Heart, 83, 24, 10.1136/heart.83.1.24 · DOI
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Subbiah, R. N., Chia, P., Leong‐Sit, P., Gula, L. J., Skanes, A. C., Yee, R. K., Klein, G. J., & Krahn, A. D. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4978-1_15
Brignole, M., Blanc, J., Sutton, R., & Moya‐Mitjans, À. (2009) · doi:10.1093/med/9780199566990.003.026
Moya‐Mitjans, À., Rivas‐Gándara, N., Sarrias, A., Pérez‐Rodon, J., & Roca‐Luque, I. (2012) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2012.03.004
Adrian-Lancelle, M., & Trinh-Duc, A. (2023) · EMC - Urgenze · doi:10.1016/s1286-9341(23)47925-2
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Mechanical Aspects of Cardiac Performance
Vinagre, R., Perry, T. E., Quill, J. L., Iaizzo, P. A., Reifart, J., & Loushin, M. K. (2024) · Springer eBooks · doi:10.1007/978-3-031-72581-4_19
Management und Therapie der vasovagalen Synkope
Aydin, M. A., & Willems, S. (2012) · Der Kardiologe · doi:10.1007/s12181-011-0394-3
Stellenwert diagnostischer Methoden in der Synkopenabklärung
Strotmann, C., Rüb, N., & Wolpert, C. (2011) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-011-0129-y
Metadata
- Authors
- Deharo, J.-C., Jego, C., Lanteaume, A., & Djiane, P.
- Affiliations
- Hôpital de la Timone (FR)
- Corresponding author
- Deharo, Jean-Claude
- ORCID
- Deharo, Jean-Claude
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-02
- Volume
- 47
- Issue
- 3
- Pages
- 587-593
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W24220055
- Cited by
- 110
- References
- 25
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 6 · 2014: 9 · 2013: 12 · 2012: 8
- FWCI
- 12.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College 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
- vasovagal syncope, implantable loop recorder, head-up tilt, cardioinhibitory syncope, bradycardia, sinus arrest, asystole, cardiac rhythm, syncope recurrence
- MeSH terms
- Adenosine Triphosphate, Aged, Aged, 80 and over, Female, Heart Rate, Humans, Male, Middle Aged, Recurrence, Electrocardiography, Ambulatory, Tilt-Table Test, Syncope, Vasovagal
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