Key result
Management of vasovagal syncope involves non-pharmacological and pharmacological options, including midodrine and SSRIs, while cardiac pacing remains controversial but potentially useful in severe cases.
This review summarizes the management of vasovagal syncope, highlighting the use of midodrine, selective serotonin reuptake inhibitors, and the controversial role of cardiac pacing for severe bradycardia or asystole.
May inform initial management choices; leaves open pacing efficacy and need for confirmatory RCTs.
Vasovagal syncope is a common cause of recurrent syncope. Clinically, these episodes may present as an isolated event with an identifiable trigger, or manifest as a cluster of recurrent episodes warranting intensive evaluation. The mechanism of vasovagal syncope is incompletely understood. Diagnostic tools such as implantable loop recorders may facilitate the identification of patients with arrhythmia mimicking benign vasovagal syncope. This review focuses on the management of vasovagal syncope and discusses the non-pharmacological and pharmacological treatment options, especially the use of midodrine and selective serotonin reuptake inhibitors. The role of cardiac pacing may be meaningful for a subgroup of patients who manifest severe bradycardia or asystole but this still remains controversial.
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Muhammet Ali Aydin (2010) conducted a review in Vasovagal syncope. Management and therapy (midodrine, SSRIs, cardiac pacing) was evaluated. Management of vasovagal syncope involves non-pharmacological and pharmacological options, including midodrine and SSRIs, while cardiac pacing remains controversial but potentially useful in severe cases.
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