Trauma (0.001<p<0.005), male sex (0.01<p<0.025), and hypertension (0.01<p<0.025) were identified as significant predisposing factors for cardioinhibitory syncope during tilt table testing.
Observational (n=989)
No
What are the pre-test predisposing factors for cardioinhibitory syncope during tilt table testing in patients with suspected syncope?
Trauma, male sex, and hypertension are independent predisposing factors for cardioinhibitory syncope during tilt table testing, which may help identify patients eligible for pacing.
Absolute Event Rate: 51% vs 20.3%
Abstract Introduction Vasovagal syncope is the most common type of syncope. It can be distinguished in vasodepressor or cardioinhibitory form. The presence of cardioinhibitory component is important in the management of syncope, leading to consider the implantation of a pacemaker. Purpose To assess the prevalence of the cardioinhibitory syncope induced by a tilt table test in both typical and atypical neurally mediated syncope (NMS); to identify some pre-test predisposing factors for cardioinhibitory syncope; and, consequently, to evaluate how many patients can be correctly eligible for pacing. Methods In the last 6 years, 989 patients were referred to our department with a diagnosis of suspected syncope. All these patients underwent the tilt table test, by using the Italian protocol. The prevalence of cardioinhibitory syncope was assessed trough the VASIS classification (2b). We compared the positive response to the typical or atypical NMS presentation. In patients with cardioinhibitory syncope, some characteristics such as hypertension, syncope with trauma, sex and age were examined, as pre-test predisposing factors. All data were studied with the odds ratio (OR) and chi-squared test with Yates correction. Finally, we studied the correct indication of pacing in all patients with cardioinhibitory syncope. Results From the initial population of 989 patients, only 640 (64.8%) have manifested syncope. Furthermore, syncope occurred roughly in 50.4% in the atypical NMS and in 75% in the typical NMS. In the subgroup of patients with syncope at tilt test, almost 65% presented a typical NMS, while the remain 35% an atypical presentation. Of 640 patients with syncope, 30% had a 2B response, representing the CI syncope, and those who were enlisted to find some pre-test predisposing factors. More in detail, the cardioinhibitory syncope was present roughly in 51.0% in patients with atypical NMS and in the 20.3% in patients with typical NMS. For whom it concerns hypertension (HT) we obtained a 0.01 p-value 0.025. For whom it concerns trauma, we obtained a 0.001 p-value 0.005. For whom it concerns male sex, we obtained a 0.01 p-value 0.025. For whom it concerns age 40, we obtained a p-value 0.05. Lastly, of 192 patients who had a response 2B to tilt-test, pacing can be effective in 20.83% Conclusions Syncope represents an event defined as benign but with a fairly major impact on life. Tilt table test has found to be effective on the induction of syncope and on the identification of cardioinhibition. We demonstrated as factors such as trauma, male sex, and hypertension can be a possible independent factors for cardioinhibitory syncope and can be helpful in the evaluation and management of patient, also including pacing. The reason for which results from age linked to a non-significant association can be related to an elderly population in which syncope was linked to a vasodepressor mechanism or also due to OH or even drug induced.Observed Vs Expected Frequencies CI syncope Vs typical or atypical NMS
Salerno et al. (Sat,) conducted a observational in Suspected syncope (n=989). Tilt table test was evaluated on Cardioinhibitory syncope in atypical vs typical neurally mediated syncope. Trauma (0.001<p<0.005), male sex (0.01<p<0.025), and hypertension (0.01<p<0.025) were identified as significant predisposing factors for cardioinhibitory syncope during tilt table testing.