The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Syncope Predicts the Outcome of Cardiomyopathy Patients
Open accessAbstract
Objectives The outcome of congestive heart failure (CHF) patients with syncope is understood incompletely.Background We analyzed data from patients enrolled in the SCD-HeFT (Sudden Cardiac Death Heart Failure Trial) to determine whether syncope predicted outcomes in patients with CHF.Methods We compared outcomes (and associated clinical characteristics) in patients with and without syncope enrolled in SCD-HeFT.Results In SCD-HeFT, 162 (6%) patients had syncope before randomization, 356 (14%) had syncope after randomization (similar incidence in each randomized arm), and 46 (2%) had syncope before and after randomization. A QRS duration >or=120 ms and absence of beta-blocker use predicted syncope during follow-up (hazard ratio [HR] 1.30 and 95% confidence interval [CI] 1.06 to 1.61, p = 0.014 and HR 1.25, 95% CI 1.01 to 1.56, p = 0.048, respectively). Syncope recurrence did not differ by randomization arm. However, in the implantable cardioverter-defibrillator (ICD) arm, syncope, before and after randomization, was associated with appropriate ICD discharges (HR 1.75, 95% CI 1.10 to 2.80, p = 0.019 and HR 2.91, 95% CI 1.89 to 4.47, p = 0.001, respectively). Post-randomization syncope predicted total and cardiovascular death (HR 1.41, 95% CI 1.13 to 1.76, p = 0.002 and HR 1.55, 95% CI 1.19 to 2.02, p = 0.001, respectively). The elevated relative risk of mortality for syncope versus non-syncope patients did not vary significantly across treatment arms (ICD, HR 1.54, 95% CI 1.04 to 2.27; amiodarone, HR 1.33, 95% CI 0.91 to 1.93; and placebo, HR 1.39, 95% CI 0.96 to 2.02, test for difference p = 0.86).Conclusions For CHF patients with ICDs, syncope was associated with appropriate ICD activations. Syncope was associated with increased mortality risk in SCD-HeFT regardless of treatment arm (placebo, amiodarone, or ICD).
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“Although ICD may not prevent syncope recurrence in these patients, 31,348 it is indicated to reduce the risk of SCD”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [31]
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
“When indicated, ICD prevents SCD but it may be unable to prevent syncope due to VT recurrence. 31,348”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [31]
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
“In patients with New York Heart Association class III–IV HF, syncope is present in 12% to 14% of patients (46,47).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [46]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Structural heart disease 25-27,31,35,36,45 and primary electrical disease 46 are major risk factors for sudden cardiac death (SCD) and overall mortality in patients with syncope.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [31]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Arrhythmic syncope is highly probable when the ECG shows 25-39 : • Persistent sinus bradycardia <40 b.p.m. or sinus pauses >3 s in awake state and in absence of physical training; • Mobitz II second- and third-degree AV block; • Alternating left and right BBB; • VT or rapid paroxysmal SVT;”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [31]
Experimental — accuracy not yet measured
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Cardiac ischaemia-related syncope is confirmed when syncope presents with evidence of acute myocardial ischaemia with or without myocardial infarction. 25-39”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [31]
Experimental — accuracy not yet measured
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Citations
Cites
Amiodarone or an Implantable Cardioverter–Defibrillator for Congestive Heart Failure
Bardy, G. H., Lee, K. L., Mark, D. B., Poole, J. E., Packer, D. L., Boineau, R., Domanski, M., Troutman, C., Anderson, J., Johnson, G., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043399 · Cited by 6,552
Self-citationIncidence and Prognosis of Syncope
Soteriades, E. S., Evans, J. C., Larson, M. G., Chen, M. H., Chen, L., Benjamin, E. J., & Levy, D. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa012407 · Cited by 1,364
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
AHA/ACCF Scientific Statement on the Evaluation of Syncope
Strickberger, S. A., Benson, D. W., Biaggioni, I., Callans, D. J., Cohen, M. I., Ellenbogen, K. A., Epstein, A. E., Friedman, P. A., Goldberger, J. J., Heidenreich, P. A., et al. (2006) · Circulation · doi:10.1161/circulationaha.105.170274 · Cited by 331
Shen, W. K., Decker, W. W., Smars, P. A., Goyal, D. G., Walker, A. E., Hodge, D. O., Trusty, J. M., Brekke, K. M., Jahangir, A., Brady, P. A., et al. (2004) · Circulation · doi:10.1161/01.cir.0000149236.92822.07 · Cited by 318
Syncope in advanced heart failure: high risk of sudden death regardless of origin of syncope
Middlekauff, H. R., Stevenson, W. G., Stevenson, L. W., & Saxon, L. A. (1993) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(93)90724-f · Cited by 311
Risk stratification of patients with syncope
Martin, T. P., Hanusa, B. H., & Kapoor, W. N. (1997) · Annals of Emergency Medicine · doi:10.1016/s0196-0644(97)70217-8 · Cited by 285
Knight, B. P., Goyal, R., Pelosi, F., Flemming, M. A., Horwood, L. E., Morady, F., & Strickberger, S. A. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00148-5 · Cited by 216
Is syncope a risk factor for poor outcomes? comparison of patients with and without syncope
Kapoor, W. N., & Hanusa, B. H. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(95)00052-6 · Cited by 180
AHA/ACCF Scientific Statement on the Evaluation of Syncope
Strickberger, S. A., Benson, D. W., Biaggioni, I., Callans, D. J., Cohen, M. I., Ellenbogen, K. A., Epstein, A. E., Friedman, P. A., Goldberger, J. J., Heidenreich, P. A., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.12.019 · Cited by 127
Flagged first, then by citations
Research works printed but not linked: 2
- Racco, 2000, Long-term follow-up after syncope, Minerva Cardioangiol, 48, 69
- Poole, 2004, Analysis of implantable defibrillator shock electrograms in the Sudden Cardiac Death-Heart Failure Trial, Heart Rhythm, 1, S178
Cited by
Sorted by citations
Items 101–118 of 118
Syncope and Risk of Sudden Death
Adkisson, W. O., Krishnan, B., & Benditt, D. G. (2017) · Cardiovascular medicine · doi:10.1007/978-3-319-58000-5_19
Syncope in the Very Elderly: Diagnosis and Treatment
Kanagaratnam, L. B., & Nagaratnam, N. (2018) · Springer eBooks · doi:10.1007/978-3-319-96998-5_29
Risk Stratification in Advanced Heart Failure
Gustafsson, F. (2020) · Elsevier eBooks · doi:10.1016/b978-0-323-56699-5.00003-6
Electrophysiology Testing: Appropriate Indications in TLOC/Collapse
Sorajja, D. (2020) · Springer eBooks · doi:10.1007/978-3-030-44507-2_16
When and How: Electrophysiological Study (EPS)
Brignole, M., & Benditt, D. G. (2010) · Springer eBooks · doi:10.1007/978-0-85729-201-8_20
(2008) · Current Opinion in Cardiology · doi:10.1097/hco.0b013e32831fb366
Clinical Assessment of the Cardiac Arrhythmia Patient
Olshansky, B. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99768-0
Self-citationBrignole, M., & Benditt, D. G. (2010) · Springer eBooks · doi:10.1007/978-0-85729-201-8_13
Can, I., & Benditt, D. G. (2010) · Humana Press eBooks · doi:10.1007/978-1-60761-161-5_18
Sorajja, D., & Shen, W.-K. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99803-x
Peut-on prédire le risque rythmique d’une syncope en cas de cardiopathie ou canalopathie ?
Mansourati, J. (2022) · La Presse Médicale Formation · doi:10.1016/j.lpmfor.2022.10.011
Kahle, A., Senges, J., Hochadel, M., Brachmann, J., Thomas, D., Straube, F., Bonaventura, K., Larbig, R. K., Werner, N., Butter, C., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-37440-2
Benditt, D. G., Lü, F., & Sakaguchi, S. (2009) · Wiley eBooks · doi:10.1002/9781444309768.ch42
Clinical Presentation and Assessment of the Cardiac Arrhythmia Patient
Blondeel, M., & Vandenberk, B. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00007-8
Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
Rattanawong, P., Chao, C., Sriramoju, A., Tagle‐Cornell, C., Farina, J., Beirne, E., Girardo, M. E., Koepke, L. M., Fatunde, O. A., Ko, N. L. K., et al. (2025) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2025.100620
Driving With Syncope and Arrhythmia Disorders
Sorajja, D., & Shen, W.-K. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00052-2
Jiménez‐Candil, J., Hernández-Hernandez, J., González‐Juanatey, C., García‐Seara, J., Morinigo, J., Duran, Ö., Sánchez-García, M., Fernández-Palacios, G., Amigo, J. S., Elices, J., et al. (2026) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2026.07.027
Burlon, F., Poggiali, E., Bolognesi, M. G., Aschieri, D., & Vercelli, A. (2026) · Emergency Care Journal · doi:10.4081/ecj.2026.15166
Metadata
- Authors
- Olshansky, B., Poole, J. E., Johnson, G., Anderson, J., Hellkamp, A. S., Packer, D., Mark, D. B., Lee, K. L., & Bardy, G. H.
- Affiliations
- University of Iowa (US)
- University of Washington (US)
- The Seattle Institute for Cardiac Research (US)
- Duke University (US)
- Mayo Clinic (US)
- Corresponding author
- Olshansky, Brian
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2008-04
- Volume
- 51
- Issue
- 13
- Pages
- 1277-1282
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2135351378
- Cited by
- 119
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 1 · 2018: 11 · 2017: 20 · 2016: 2 · 2015: 9 · 2014: 7 · 2013: 14 · 2012: 8
- FWCI
- 10.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Medtronic
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- syncope, congestive heart failure, cardiomyopathy, SCD-HeFT trial, implantable cardioverter-defibrillator, mortality prediction, QRS duration, beta-blocker therapy, amiodarone, sudden cardiac death, syncope recurrence, prognostic factors, cardiovascular mortality, arrhythmic risk stratification, heart failure with reduced ejection fraction
- MeSH terms
- Adult, Amiodarone, Anti-Arrhythmia Agents, Female, Health Status, Heart Failure, Humans, Male, Middle Aged, Cardiomyopathies, Predictive Value of Tests, Prognosis, Recurrence, Risk, Risk Factors, Stroke Volume, Syncope, Time Factors, Death, Sudden, Cardiac, Treatment Outcome, Defibrillators, Implantable, Myocardial Ischemia
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