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Cited by 32Cardiovascular Syncope and Autonomic DisordersCardiac electrophysiology and arrhythmiasHeart Rate Variability and Autonomic Control

A standardized conventional evaluation of the mechanism of syncope in patients with bundle branch block

Open access
Donateo, P·2002·Europace
DOI 10.1053/eupc.2002.0265
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Abstract

BACKGROUND: The finding of bundle branch block in patients with syncope suggests that paroxysmal AV block may be the cause of syncope, even though its prevalence is unknown. METHODS: We evaluated 55 consecutive patients with syncope and bundle branch block (mean age 75 +/- 8 years; median of two syncopal episodes per patient) referred to three Syncope Units. The hierarchy and appropriateness of diagnostic tests and the definitions of the final diagnoses followed standardized predefined criteria. RESULTS: Cardiac syncope was diagnosed in 25 patients (45%): AV block in 20, sick sinus syndrome in 2, sustained ventricular tachycardia in 1, aortic stenosis in 2. Neurally mediated syncope was diagnosed in 22 (40%): carotid sinus syndrome in 5, tilt-induced syncope in 15, adenosine-sensitive syncope in 2. Syncope remained unexplained in 8 (15%). CONCLUSIONS: Less than half of the patients with bundle branch block have a final diagnosis of cardiac syncope; in these patients, paroxysmal AV block is the most frequent but not the only mechanism supposed.

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Crossref · 10.1053/eupc.2002.0265

Cites

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  • Less than half of patients with bifascicular BBB and syncope will have a final diagnosis of AV block, a similar percentage will have a final diagnosis of reflex syncope, and approximately 15% remain unexplained at the end of a complete workup.

    “Nevertheless, less than half of the patients with bifascicular BBB and syncope will have a final diagnosis of AV block, a similar percentage will have a final diagnosis of reflex syncope, and, in approximately 15%, the cause will remain unexplained at the end of a complete workup. 342”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [342]

    The Findings report AV block in 20 of 55 patients, neurally mediated syncope in 22 (40%), and unexplained syncope in 8 (15%) after the standardized workup. Those figures describe all patients with bundle branch block, not specifically the bifascicular subgroup named in the claim; the paper does not give the same diagnostic breakdown for that subgroup. (LLM, conf=0.88)

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Cites

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Research works printed but not linked: 4

  1. McAnulty JH, Rahimtoola SH, Murphy ES, et al.. Natural history of ''high-risk'' bundle branch block. N Engl J Med 1982; 307: 137-43.
  2. Gronda M, Magnani A, Occhetta E, et al.. Electrophysiologic study of atrioventricular block and ventricular conduction defects. G Ital Cardiol 1984; 14: 768-73.
  3. Dini P, Ialongo D, Adinolfi E, et al.. Prognostic value of His-ventricular conduction after ajmaline administration. In: Masoni A, Alboni P, eds. Cardiac Electrophysiology Today. London: Academic Press 1982: 515-22.
  4. Brignole M, Gigli G, Altomonte F, et al.. The cardio- inhibitory reflex evoked by carotid sinus stimulation in normal and in patients with cardiovascular disorders. G Ital Cardiol 1985; 15: 514-19.

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Authors
Donateo, P.
Corresponding author
Donateo, P
Venue
Europace
Publisher
Oxford University Press (OUP)
Published
2002-10
Volume
4
Issue
4
Pages
357-360
ISSN
1099-5129 (ISSN-L)
DOI
10.1053/eupc.2002.0265
OpenAlex
W2146267042
Cited by
32
References
27
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 1 · 2016: 2 · 2014: 2 · 2012: 2
FWCI
0.32
Type
journal article
Language
en
Open access
Locations
  • EP Europace (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
syncope, bundle branch block, paroxysmal atrioventricular block, cardiac syncope, neurally mediated syncope, carotid sinus syndrome, sick sinus syndrome, diagnostic assessment
MeSH terms
Aged, Bundle-Branch Block, Female, Heart Function Tests, Humans, Male, Syncope

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