Noninvasive tests and implantable loop recorders aid in diagnosing syncope in the elderly, while pacemaker therapy and electrophysiology-guided management offer therapeutic benefits for specific etiologies.
Answers are grounded in this paper and cite their sources.
Supports diagnostic evaluation with loop recorders in elderly syncope; leaves open need for prospective trials on pacemaker and EP strategies.
Syncope in the elderly is an important health care issue because of the large patient population, challenging diagnostic and therapeutic approaches, and potentially devastating consequences. Significant comorbidity and atypical clinical presentations render a precise determination of the cause of syncope difficult. Recent studies suggest that noninvasive tests, such as carotid sinus massage or tilt-table testing, can be helpful in the diagnostic workup. It has been shown that permanent pacemaker therapy benefits elderly patients with carotid sinus hypersensitivity, and younger patients with recurrent vasovagal syncope. The implantable wireless loop recorder can be effective in documenting transient arrhythmias as causes of syncope in selected patients. Elderly patients with syncope and a low ejection fraction are at increased risk of sudden death due to malignant ventricular arrhythmia. Electrophysiologic study and electrophysiology-guided therapy should be considered in this segment of the population.
No takes yet. Share an insight, caveat, or question.
Luria et al. (2001) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: