Key result
Non-pharmacological measures curb syncope recurrences in ~87% of vasovagal syncope patients despite low adherence.
Why the study?
The long-term effectiveness of combined non-drug treatments, treatment adherence, and quality of life in patients with vasovagal syncope (VVS) warranted investigation.
Does combined non-pharmacological therapy reduce syncope recurrence and improve quality of life in patients with vasovagal syncope?
Observational (n=46)
Does combined non-pharmacological therapy reduce syncope recurrence and improve quality of life in patients with vasovagal syncope?
Answers are grounded in this paper and cite their sources.
Combined non-pharmacological lifestyle modifications were associated with reduced syncope frequency and improved quality of life in 87% of vasovagal syncope patients over a median of 533 days, despite very low self-reported treatment adherence (96% with <50% adherence).
Objective. To study the effectiveness of combined non-drug treatments in patients with vasovagal syncope (VVS) in long-term period, adherence to treatment and quality of life. Material and methods. The study included 46 patients with VVS (≥2 recurrences in the past year). Mean age was 29.5 years; there were 20 (43.5%) women. All patients were advised with non-pharmacological methods (avoiding situations triggering VVS, fluid intake 2.5-3 liters daily, salt intake 6-9 g daily (except for patients with arterial hypertension), orthostatic training, and special maneuvers for pre-syncope symptoms). Patients completed questionnaires to assess their quality of life (EQ-5D-5L) and anxiety / depression (HADS). Adherence to lifestyle modifications was assessed using the KOP-25 questionnaire. Results. Throughout long-term period (Me=533 days), recurrent syncope occurred in 30 (65%) patients. Twenty-four (52%) patients experienced less number of relapses, and 6 (13%) patients had the same incidence of syncope. The median value of “health status” in VAS scale was 70% [60; 85]. According to HADS scale, signs of subclinical and significant anxiety were detected in 27% of cases, depression — in 23%. In long-term period, patients with VVS demonstrated better QOL indicators (median VAS 80%, 70—85% (Q1—Q3), p=0.006). Proportion of patients with depression decreased significantly. Ninety-six percent of patients with VVS demonstrated low (<50%) adherence to lifestyle modification, one patient (2.2%) had moderate (51%), and one patient (2.2%) had high (87%) adherence. Conclusion. Combined non-pharmacological treatments aimed at lifestyle modification are effective in 87% of patients with VVS in long-term period. This resulted in either absence of syncope (35%) or less number of syncope recurrences and better QoL (52%). Reduced QoL scores (EQ-5D-5L) are observed across all items, but these declines are mild. According to HADS scale, signs of subclinical and clinical anxiety are observed in 27% of VVS patients, while depression is observed in 23% of cases. Proportion of patients with depressive symptoms decreases significantly in long-term period. The KOP-25 questionnaire reveals low adherence to lifestyle modification in 95.6% of patients with VVS.
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Murtuzalieva et al. (2026) conducted an observational in Vasovagal syncope (n=46). Combined non-pharmacological treatments (trigger avoidance, 2.5-3 L/day fluid intake, 6-9 g/day salt intake, orthostatic training, pre-syncope maneuvers) was evaluated on Effectiveness in reducing or eliminating recurrent syncope. Combined non-pharmacological treatments were effective in 87% of vasovagal syncope patients (35% syncope-free, 52% fewer relapses) and improved quality of life (p=0.006), despite 95.6% low adherence.
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