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October 1, 2002EP EuropaceOpen Access

A standardized conventional evaluation of the mechanism of syncope in patients with bundle branch block

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Key result

Standardized evaluation of syncope and BBB identifies cardiac causes in ~45%, mostly AV block.

  • n=55

Population

55 consecutive patients with syncope and bundle branch block referred to three Syncope Units.

Design

Cross-sectional

Authors

PDP. Donateo

Discussion

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Overview

Standardized evaluation identifies non-cardiac causes in over half of syncope cases with bundle branch block; leaves open prospective validation of diagnostic impact.

Key Points

  • Determine the prevalence and underlying mechanisms of syncope in patients with bundle branch block using a standardized diagnostic pathway.
  • Evaluated 55 consecutive patients presenting with syncope and bundle branch block (mean age 75 ± 8 years; median of two syncopal episodes) referred to three Syncope Units.
  • Implemented a standardized diagnostic hierarchy and predefined diagnostic criteria to identify the definitive cause of syncope.
  • Cardiac syncope was diagnosed in 45% of patients (25/55), with paroxysmal atrioventricular block being the primary etiology (n=20), followed by sick sinus syndrome (n=2), aortic stenosis (n=2), and sustained ventricular tachycardia (n=1).
  • Neurally mediated syncope accounted for 40% of cases (22/55), comprising tilt-induced syncope (n=15), carotid sinus syndrome (n=5), and adenosine-sensitive syncope (n=2), while 15% (8/55) remained unexplained.

Study Design

Type

Observational (n=55)

Multicenter

Yes

Structured PICO

P
Population
55 consecutive patients (mean age 75 years) with syncope and bundle branch block referred to three Syncope Units.
E
Exposure
Standardized conventional evaluation (hierarchy and appropriateness of diagnostic tests based on predefined criteria)
O
Outcome
Final diagnosis of the mechanism of syncope

In patients with syncope and bundle branch block, less than half have a cardiac cause, highlighting the importance of a comprehensive and standardized diagnostic evaluation.

Cite This Study

P. Donateo (2002) conducted an observational in Syncope and bundle branch block (n=55). Standardized diagnostic evaluation was evaluated on Diagnosis of cardiac syncope. Standardized diagnostic evaluation in patients with syncope and bundle branch block identified cardiac syncope in 45% (mostly AV block), neurally mediated syncope in 40%, and 15% unexplained.

synapsesocial.com/papers/6aa265c474fc654bd03230b9https://doi.org/10.1053/eupc.2002.0265
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Evaluation and Outcome of Patients with Syncope1990 · 549 citations
  2. 2Natural History of High-Risk Bundle-Branch Block1982 · 318 citations
  3. 3Clinical usefulness of head-up tilt test in patients with syncope and intraventricular conduction defect1999 · 9 citations
  4. 4Do Symptoms Predict Cardiac Arrhythmias and Mortality in Patients With Syncope?1999 · 107 citations