The diagnosis of recurrent syncope in patients with pacemakers (PM) is quite challenging and the etiology of syncope is often multifactorial. To portray the mechanism of syncope in PM patients, we report the results of head-up tilt table testing (HUT) in a series of patients with PM, originally implanted for reasons other than neurally mediated syncope, referred due to syncope or pre-syncope (a...

Aims The prevalence of positive carotid sinus massage (CSM) in asymptomatic elderly persons and related risk of syncope are poorly known. Methods and results We examined the ability of CSM to predict the risk of profound bradycardia or syncope in 30 patients with Alzheimer’s disease (AD) and no history of syncope, before treatment with cholinesterase inhibitors. Carotid sinus massage was repeat...

Syncope has been defined as a transient, brief, self-limited loss of consciousness due to global cerebral hypoperfusion (Brignole et al. 2004). The specific pathophysiology sets syncope apart from other conditions causing transient loss of consciousness (TLOC), such as epilepsy. The major causes and mimics of TLOC are summarised in figure 1. History-taking is the most important tool to distingu...

Syncope is a clinical syndrome characterized by transient loss of consciousness and postural tone that is most often due to temporary and spontaneously self-terminating global cerebral hypoperfusion. A common presenting problem to health care systems, the management of syncope imposes a considerable socioeconomic burden. Clinical guidelines, such as the European Society of Cardiology Guidelines...

OBJECTIVES This study assessed the heart variability response to orthostatic stress during tilt table testing before and after normal saline administration. BACKGROUND The efficacy of sodium chloride and mineralocortoid in the treatment of neurally mediated cardiac syncope is attributed to intravascular volume expansion; however, their modulation of autonomic nervous system activity has not b...

Background: Neurocardiogenic syncope is well known as the most frequent cause of syncope in childhood. The head-up tilt table test (HUTT) is now widely used to evaluate patients with unexplained syncope. Although many reports have reported on children associated with neurocardiogenic syncope, the relationship between the clinical characteristics of those patients and the results of the HUTT rem...

Syncope is defined as a sudden temporary loss of consciousness and postural tone that is associated with spontaneous recovery. Vasovagal or neurocardiogenic syncope is a common and usually benign cause of syncope. The mechanism may be cardioinhibitory, vasodepressor, or both. Diagnosis is usually made by a typical patient history with a definite trigger. Although vasovagal syncope is considered...

For the diagnosis of reflex syncope, diligent history-building with the patient and a witness is required. In the Emergency Department (ED), the assessment of syncope is a challenge which may be addressed by an ED Observation Unit or by a referral to a Syncope Unit. Hospital admission is necessary for those with life-threatening cardiac conditions although risk stratification remains an unsolve...

Syncope is defined as a sudden transient loss of consciousness and postural tone due to cerebral hypoperfusion. Although no permanent medical sequelae should result from syncope itself, isolated or recurrent events are often dramatic and disrupt the lifestyle of affected individuals. Syncope is a common clinical problem that affects up to 3.5% of the general population.1 Strikingly, in close to...

BACKGROUND Because of its episodic behavior, the correlation of spontaneous syncope with an abnormal finding can be considered a reference standard. METHODS AND RESULTS We inserted an implantable loop recorder in 111 patients with syncope, absence of significant structural heart disease, and a normal ECG; tilt-testing was negative in 82 (isolated syncope) and positive in 29 (tilt-positive). T...