Treatment of Reflex Syncope
Open accessAbstract
This review assesses the role of all types of therapy for reflex syncope including physical counter-measures, diet, behavior, drugs and implantable devices. There are no drugs currently demonstrated to have convincingly beneficial effect by randomized controlled trial. However, provided that the patient experiences warning of an impending attack physical counter-measures are demonstrably effective. Implantable cardiac pacemakers have a role in a carefully selected minority of patients with vasovagal syncope. Pacing, dual chamber of cardio-inhibitory Carotid Sinus Syndrome is the treatment of choice. Modification of lifestyle in terms of fluid, caffeine and salt consumption is necessary in many cases but has little scientific background. Educating and reassuring the patient is an important part of management. The patient must understand that attacks are not as dangerous as they might seem in most cases and learning to anticipate those permits evasive measures.
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Results of lifestyle and medical therapies have generally been positive in uncontrolled and short-term controlled trials, but long-term placebo-controlled prospective trials have been less encouraging.
“While results have generally been positive in uncontrolled trials and short-term controlled trials, those of long-term, placebo-controlled prospective trials have been less encouraging.”
Cites
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Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013 · see citing works
Self-citation
- Authors
- Sutton, R.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Sutton, Richard
- ORCID
- Sutton, Richard
- Venue
- Journal of Medical Diagnostic Methods
- Publisher
- OMICS Publishing Group
- Published
- 2013
- Volume
- 02
- Issue
- 05
- ISSN
- 2168-9784 (ISSN-L)
- OpenAlex
- W2334789362
- Cited by
- 1
- References
- 23
- Citations by year
- 2015: 1
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Diagnostic Methods (publishedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- reflex syncope, vasovagal syncope, carotid sinus syndrome, implantable pacemaker, DDD pacing, lifestyle modification, caffeine, salt intake, fluid intake, pharmacotherapy, patient education
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