Mid-term follow-up of patients with vasovagal syncope

Abstract

OBJECTIVE: In this study, we aimed to evaluate 3-year mid-term follow-up results that consist of treatment response, frequency of recurrences, predisposing factors that cause recurrence and prognosis in patients with syncope and presyncope. We also aimed to obtain useful information that will contribute to follow-up and treatment of these patients. METHODS: 285 consecutive patients diagnosed with syncope between January 2008 and December 2009 were enrolled into study. Patients files were rewieved retrospectively. Etiology of syncope in these patients were evaluated. 114 patients were diagnosed with vasovagal syncope. RESULTS: Vasovagal syncope 51.2 %, pseudo-syncope 22.1%, syncope with neurological origin 14.4%, cardiac syncope 2,1 % and unexplained syncope 10.2 % were found in 285 patients that were examined for syncope. 114 patients diagnosed with vasovagal syncope. Of those 58.8% female, 41.2% were male. Female to male ratio was 1,4. Mean age at presentation 11.7 ± 2.5 years, the mean age of first syncope 11.3 ± 5.2 years, and the mean duration of follow-up 42.8 ± 3.4 months were found. During the follow-up period recurrence of syncope was found in 31 patients (27.2%). Any effects of sex, absence or persence of prodromal symptoms, response type to tilt table test at the time of diagnosis was not determined on the reccurence and type of syncope. Significant decrease was seen in the number of syncope attacks after the tilt table test. The recurrence of syncope was observed in 15 of 26 patients that were treated with beta blockers,whereas 16 of 88 untreated patients. Reccurence of syncope were found more frequent in patients with drug therapy. CONCLUSION: In childhood period, education and recommendations, increasing fluid and salt intake are successful form of treatment for vasovagal syncope. In patients with recurrent syncope attacks β blocker treatment is used besides the recommendations. But effect of the beta blocker therapy for preventing the recurrence is limited. For this reason, medication should be used only in cases with frequently repeated vasovagal syncope attacks.