Key result
High cardio-electrophysiological balance index is linked to ~136% higher 1-year recurrence of pediatric VVS.
Why the study?
Pediatric vasovagal syncope is prone to relapse and impairs quality of life, prompting evaluation of the index of cardio-electrophysiological balance for diagnosing VVS and predicting its recurrence.
Does the index of cardio-electrophysiological balance (iCEB) predict the diagnosis and recurrence of vasovagal syncope in pediatric patients?
Cohort (n=199)
No
Does the index of cardio-electrophysiological balance (iCEB) predict the diagnosis and recurrence of vasovagal syncope in pediatric patients?
The index of cardio-electrophysiological balance (iCEB) is a useful non-invasive ECG marker for diagnosing pediatric vasovagal syncope and predicting its 1-year recurrence.
Answers are grounded in this paper and cite their sources.
May inform recurrence risk stratification in pediatric VVS; leaves open prospective validation before any practice change.
Aims/Objective Pediatric vasovagal syncope (VVS) is prone to relapse and affects the quality of patients’ lives. The current study aims to assess the predictive value of the index of cardio-electrophysiological balance (iCEB) for both diagnosis and recurrence of pediatric VVS, to enhance precision in clinical management. Methods This retrospective cohort study analysed 199 syncope patients treated at the First Hospital of Jilin University between January 2019 and December 2023. Participants were stratified into VVS (n = 79) and non-VVS (n = 120) groups. Univariate analysis and binary logistic regression were performed to identify predictors for VVS, while correlations between variables were assessed using Spearman/Pearson/point-biserial correlation coefficients. Predictive value was assessed using receiver operating characteristic (ROC) curve analysis. Results Family syncope history, prolonged standing triggers, iCEB, QT interval (QT), and QRS duration (QRS) showed significant differences between the two groups (p < 0.05). iCEB correlated negatively with QRS (r = –0.612, p < 0.001), and positively with QT (r = 0.403) and prolonged standing triggers (r = 0.164) (both p < 0.05). Logistic regression identified iCEB (odds ratio [OR] = 1.251, 95% confidence interval [CI]: 1.136–1.378, per 0.1 units, p < 0.001) and family syncope history (OR = 2.369, 95% CI: 1.192–4.708, p = 0.014) as independent predictors. ROC curve analysis demonstrated that iCEB has superior accuracy in predicting the recurrence of VVS (area under the curve [AUC] = 0.710, 95% CI: 0.634–0.786; sensitivity 65.83%, specificity 70.89% at cutoff 4.086). The high-iCEB patients (≥4.086, n = 56) exhibited a 2.36-fold higher 1-year recurrence rate than their low-iCEB counterparts (41.07% vs. 17.39%, p = 0.044). Conclusion iCEB demonstrates strong predictive value in diagnosing pediatric VVS, and higher iCEB levels are linked to an increased risk of recurrence within one year, making it a useful reference indicator for recurrence.
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Xin et al. (2025) conducted a cohort in Pediatric vasovagal syncope (VVS) (n=199). High index of cardio-electrophysiological balance (iCEB ≥4.086) vs. Low iCEB (<4.086) was evaluated on 1-year recurrence of VVS (p=0.044). High index of cardio-electrophysiological balance (≥4.086) was associated with a higher 1-year recurrence rate of pediatric vasovagal syncope compared to lower levels (41.07% vs. 17.39%, p=0.044).
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