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Cited by 125Cardiovascular Syncope and Autonomic DisordersCardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmias

Significance of inducible tachycardia in patients with syncope of unknown origin: A long-term follow-up

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Olshansky, Brian, Mazuz, Meir, Martins, James B.·1985·Journal of the American College of Cardiology
DOI 10.1016/s0735-1097(85)80040-1
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Abstract

The frequency of inducible tachycardia was assessed in patients presenting with syncope whose noninvasive evaluation did not reveal a cause for syncope. It was also determined whether treatment of tachyarrhythmias during programmed electrical stimulation would prevent recurrence of syncope. One hundred five patients were studied and 97 were followed up for a mean period of 25.8 months. Sixty-eight patients (65%) did not have inducible tachycardia. Sixty of these 68 patients could be followed up; 12 (20%) had recurrent syncope. Ventricular or supraventricular tachycardia was inducible in 37 patients (35%). The frequency of organic heart disease was not higher in this group or in those with inducible ventricular tachycardia as compared with those with inducible supraventricular tachycardia. Three patients with inducible ventricular tachycardia died suddenly or were resuscitated from cardiac arrest, and an additional seven had recurrent syncope; thus, the total recurrence rate was 27%. Of 23 patients undergoing effective therapy as predicted by electrophysiologic testing, 3 (14%) had a recurrent event. Results were significantly different in patients receiving ineffective therapy as judged by electrophysiologic testing. Of 13 patients in this latter category, 7 patients (54%) had recurrence of syncope or cardiac arrest (p less than 0.05). In three patients, recurrence took place a mean of 5 months after cessation of therapy; on resumption of effective therapy, no syncope recurred for 15.6 months (p less than 0.025). Tachycardia is frequently induced in patients with syncope of unknown origin, whether or not organic heart disease is present. Treatment of inducible tachycardia may prevent recurrence of syncope.

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  • The role of EPS in patients with syncope suspected to be due to VA and acquired nonischemic heart disease is unproven.

    “The role of EPS in patients with syncope suspected to be due to VA and acquired nonischemic heart disease is unproven (193–198).”

    From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [198]

    Table 3 (Discussion; page not given) includes five patients with cardiomyopathy, but it does not assess whether the role of EPS is proven or unproven for patients with acquired nonischemic heart disease. Searches for that qualification and for conclusions about EPS in this subgroup found no decisive passage in our copy. (LLM, conf=0.70)

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References 33 · Cited by 125

Research works printed but not linked: 62

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  42. Altschuler H, Fisher 10, Furman S. Significance of isolated H-Y interval prolongation in symptomatic patients with documented heart block. Am Heart J 1979;97: 19-26.
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  60. Josephson ME, Horowitz LN, Spielman SR, Greenspan AM. Elec- trophysiologic and hemodynamic studies in patients resuscitated from cardiac arrest. Am J Cardiol 1980;46:948-55.
  61. Morady F, Scheinman MM, Hess OS, Sung RJ. Shen E, Shapiro W. Electrophysiologic testing in management of survivors of out-of- hospital cardiac arrest. Am J Cardiol 1983;51 :85-9.
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Authors
Olshansky, B., Mazuz, M., & Martins, J. B.
Affiliations
University of Iowa Hospitals and Clinics (US)
Corresponding author
Martins, James B.
ORCID
Olshansky, Brian
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1985-02
Volume
5
Issue
2
Pages
216-223
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/s0735-1097(85)80040-1
OpenAlex
W2028254846
Cited by
125
References
33
Citations by year
2024: 1 · 2022: 1 · 2021: 1 · 2018: 1 · 2017: 4 · 2015: 1 · 2014: 1 · 2013: 3
FWCI
11.44
Type
journal article
Language
en
Open access
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 › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
syncope of unknown origin, ventricular tachycardia, supraventricular tachycardia, programmed electrical stimulation, syncope recurrence, cardiac arrest, organic heart disease, long-term follow-up
MeSH terms
Adolescent, Adult, Aged, Anti-Arrhythmia Agents, Atrioventricular Node, Cardiac Pacing, Artificial, Child, Electric Stimulation, Electrophysiology, Female, Follow-Up Studies, Heart Atria, Heart Ventricles, Humans, Male, Middle Aged, Recurrence, Syncope, Tachycardia

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