ACC/AHA/HRS Versus ESC Guidelines for the Diagnosis and Management of Syncope
Open accessAbstract
Syncope is a commonly encountered and challenging problem in medical practice. Presentations are variable, and the causal mechanism often remains elusive even after extensive (and often expensive) evaluation. Clinical practice guidelines have been developed to help guide the multidisciplinary approach necessary to diagnose and manage the broad spectrum of patients presenting with syncope. The American College of Cardiology/American Heart Association, in collaboration with the Heart Rhythm Society, published its first syncope guidelines in 2017. The European Society of Cardiology released the fourth iteration of its syncope guidelines in 2018. This review highlights the differences and congruencies between the 2 sets of recommendations, their implications for clinical practice, the remaining gaps in understanding, and areas of future research.
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International guidelines recommend ILR implantation in patients with unexplained recurrent syncope after a standard workup.
“While international guidelines recommend ILR implantation in patients with unexplained recurrent syncope after a standard workup [5,22,23,24],”
From Diagnostic Yield and Clinical Implications of Implantable Loop Recorders in Patients with Syncope in Germany: A National Database Analysis (2024) · cites this paper as [23]
Table 2 (section labeled Conclusions; page unavailable) reports an ESC Class I recommendation for implantable loop recorders in selected patients with recurrent syncope of uncertain origin, including some whose comprehensive evaluation found no cause. The claim omits the ESC eligibility conditions and presents the U.S. recommendation more broadly than the table does: it applies when an arrhythmic cause is suspected. (LLM, conf=0.83)
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References 53 · Cited by 82
Research works printed but not linked: 1
- [41]41. Raviele A, Giada F, Menozzi C, et al. A randomized, double-blind, placebocontrolled study of permanent cardiac pacing for the treat- ment of recurrent tiltinduced vasovagal syncope. The vasovagal syncope and pacing trial (SYN- PACE). Eur Heart J 2004;25:1741-8.
- Authors
- Goldberger, Z. D., Petek, B. J., Brignole, M., Shen, W.-K., Sheldon, R. S., Solbiati, M., Deharo, J.-C., Moya, A., & Hamdan, M. H.
- Affiliations
- University of Wisconsin–Madison (US)
- Massachusetts General Hospital (US)
- Presidio Ospedaliero (IT)
- Mayo Clinic (US)
- University of Calgary (CA)
- University of Milan (IT)
- Hôpital de la Timone (FR)
- Corresponding author
- Goldberger, Zachary D.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 74
- Issue
- 19
- Pages
- 2410-2423
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2988779793
- Cited by
- 82
- References
- 53
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 15 · 2023: 19 · 2022: 18 · 2021: 7 · 2020: 4
- FWCI
- 6.93
- 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 › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- syncope, ESC guidelines, guideline comparison, syncope diagnosis, syncope management, syncope etiology, cardiovascular syncope
- MeSH terms
- American Heart Association, Humans, Societies, Medical, Syncope, United States, Practice Guidelines as Topic
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