Open Access

The triggers of situational syncope do not influence the head-up tilt test response and prognosis

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Date: 6 August 2024
Journal: EP Europace Journal , Volume 26 , Issue 9
Topic: ARRHYTHMIAS AND DEVICE THERAPY, OTHER, European Society of Cardiology, Syncope and Bradycardia
Authors: V. Russo , E. Parente , A. Comune , A. Rago , G. Nigro , M. Brignole

ESC Journals

AbstractAims

The study evaluated the positivity rate, haemodynamic responses, and prognosis in terms of syncopal recurrence among patients with situational syncope (SS) stratified according to the underlying situational triggers.

Methods and results

We retrospectively evaluated all consecutive patients with SS who underwent nitroglycerine (NTG)-potentiated head-up tilt test (HUTT) at Syncope Unit of the University of Campania ‘Luigi Vanvitelli’—Monaldi Hospital from 1 March 2017 to 1 May 2023. All patients were followed for at least one year. The study population was divided according to the underlying triggers (micturition, swallow, defaecation, cough/sneeze, post-exercise). Two hundred thirty-six SS patients (mean age 50 ± 19.3 years; male 63.1%) were enrolled; among them, the situational trigger was micturition in 109 patients (46.2%); swallow in 32 (13.6%) patients; defaecation in 35 (14.8%) patients; post-exercise in 41 (17.4%) patients; and cough/sneeze in 17 (7.2%) patients. There were no significant differences in baseline clinical characteristics and HUTT responses between different situational triggers. The Kaplan–Meier analysis did not show a statistically different rate of syncope recurrence across patients stratified by baseline situational triggers (log-rank P = 0.21).

Conclusion

Situational syncope appears to be a homogenous syndrome, and different triggers do not impact the HUTT response or syncope recurrence at 1 year.

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About the contributors

Vincenzo Russo

Role: Author

Erika Parente

Role: Author

Angelo Comune

Role: Author