The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Mechanism of Syncope in Patients With Heart Disease and Negative Electrophysiologic Test
Abstract
BACKGROUND: In patients with syncope and structural heart disease, syncope is suspected to be attributable to a primary cardiac arrhythmia, but little is known of its mechanism when electrophysiologic study is unremarkable. METHODS AND RESULTS: We applied an implantable loop recorder in 35 patients with overt heart disease at risk of ventricular arrhythmia, because these were patients with previous myocardial infarction or cardiomyopathy with depressed ejection fraction or nonsustained ventricular tachycardia in whom an electrophysiologic study was unremarkable. During a follow-up of 3 to 15 months, syncope recurred in 6 patients (17%) after a mean of 6+/-5 months; in 3 patients, the mechanism of syncope was bradycardia with long pauses (sudden-onset AV block in 2 cases and sinus arrest in 1 case); in 1 patient, there was stable sinus tachycardia; and in 2 patients, who had chronic atrial fibrillation, there was an increase in ventricular rate. A total of 23 episodes of presyncope were documented in 8 patients (23%): no rhythm variation or mild tachycardia in 12 cases, paroxysmal atrial fibrillation or atrial tachycardia in 10 cases, and sustained ventricular tachycardia in 1 case. No patient died during the study period nor suffered from injury attributable to syncopal relapse. CONCLUSIONS: The patients with unexplained syncope, structural heart disease, and negative electrophysiologic study had a favorable medium-term outcome with no case of death and a low recurrence rate of syncope without related injury. The mechanism of syncope was heterogeneous, and ventricular tachyarrhythmia was unlikely.
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“Similar findings were subsequently observed with ILR use expanded in an early phase of evaluation in patients with recurrent syncope of uncertain origin, in the absence of highrisk criteria and structural heart disease, 176,180-183 and in suspected reflex syncope. 184-186 In particular, an asystolic pause was present during syncope in about 50% of these patients.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [180]
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Citations
Cites
Risk Stratification and Survival after Myocardial Infarction
The Multicenter Postinfarction Research Group (1983) · New England Journal of Medicine · doi:10.1056/nejm198308113090602 · Cited by 1,599
Guidelines on management (diagnosis and treatment) of syncope
Brignole, M. (2001) · European Heart Journal · doi:10.1053/euhj.2001.2739 · Cited by 951
Diagnostic value of history in patients with syncope with or without heart disease
Alboni, P., Brignole, M., Menozzi, C., Raviele, A., Del Rosso, A., Dinelli, M., Solano, A., & Bottoni, N. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01241-4 · Cited by 444
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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
Self-citationUse 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
Mechanism of syncope in patients with bundle branch block and negative electrophysiological test
Brignole, M., Menozzi, C., Moya, A., Garcia-Civera, R., Mont, L., Alvarez, M., Errazquin, F., Beiras, J., Bottoni, N., Donateo, P., et al. (2001) · Circulation · doi:10.1161/hc4201.097837 · Cited by 328
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
Risk Factors for Syncope Recurrence After a Positive Tilt-Table Test in Patients With Syncope
Sheldon, R. S., Rose, S., Flanagan, P., Koshman, M. L., & Killam, S. (1996) · Circulation · doi:10.1161/01.cir.93.5.973 · Cited by 231
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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Myerburg, R. J., Quiñones, M. A., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.010 · Cited by 1,975
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.178233 · Cited by 1,080
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Moss, A. J., Myerburg, R. J., et al. (2006) · EP Europace · doi:10.1093/europace/eul108 · Cited by 741
Metadata
- Authors
- Menozzi, C., Brignole, M., Garcia-Civera, R., Moya, A., Botto, G., Tercedor, L., Migliorini, R., & Navarro, X.
- Affiliations
- Hospital Clínico Universitario de Valencia (ES)
- From the Department of Cardiology, Ospedale S. Maria Nuova (C.M.), Reggio Emilia; Ospedali del Tigullio (M.B.), Lavagna; Ospedale S. Anna (G.B.), Como; and Medtronic Italy (R.M.), Milan, Italy; and Hospital General Vall d’Hebron (A.M.), Barcelona; Hospital Clinico Universitario (R.G.C.), Valencia; Hospital Virgen de las Nieves (L.T.), Granada; and Medtronic Iberica (X.N.), Madrid, Spain.
- Corresponding author
- Brignole, Michele
- Venue
- Circulation
- Published
- 2002-06-11
- Volume
- 105
- Issue
- 23
- Pages
- 2741-2745
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2153070746
- Cited by
- 204
- References
- 22
- Citations by year
- 2026: 2 · 2024: 4 · 2023: 3 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 5 · 2014: 13 · 2013: 17 · 2012: 9
- FWCI
- 12.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- syncope, structural heart disease, implantable loop recorder, ventricular tachyarrhythmia, atrial fibrillation, sinus arrest, atrioventricular block, presyncope, ventricular tachycardia, cardiomyopathy, myocardial infarction, syncope recurrence
- MeSH terms
- Aged, Arrhythmias, Cardiac, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Cardiomyopathies, Syncope, Disease-Free Survival, Prostheses and Implants, Electrophysiologic Techniques, Cardiac, Endpoint Determination
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