δείτε την πρωτότυπη σελίδα τεκμηρίου στον ιστότοπο του αποθετηρίου του φορέα για περισσότερες πληροφορίες και για να δείτε όλα τα ψηφιακά αρχεία του τεκμηρίου*
Neurocardiogenic syncope - Aetiology and management
Neurocardiogenic syncope is the most common cause of syncope presenting
in the outpatient setting. It is usually encountered among individuals
without an underlying heart disease, but not uncommonly participates in
the syncope mechanism of patients with an obstructive or an arrhythmic
cardiac cause for syncope as well. The vasovagal event is caused by a
transient profound hypotensive reaction most commonly associated with
inappropriate bradycardia resulting from activation of a complex
autonomic reflex. The pathophysiology of neurocardiogenic syncope has
been elucidated by tilt table testing, a noninvasive and well-tolerated
method for reproducing the event in susceptible individuals.
Although the majority of people with vasovagal fainting need no specific
treatment, treatment is required for those presenting with problematic
features such as frequent events accompanied by trauma or accidents, and
occasionally by a severe cardioinhibitory pattern response. A number of
different drugs have been proposed to favourably act on different
aspects of the neurocardiogenic reflex but only a few randomised,
placebo-controlled, drug-specific trials are currently available.
Alternatively, cardiac pacing has also been introduced for patients who
have symptoms that are drug-refractory or for those with a severe
cardioinhibitory hypotensive response.
The selection of the appropriate treatment plan should be individualised
after consideration of patient history, clinical characteristics and
preference, results of the baseline tilting study, and the existing
evidence from the few randomised, controlled studies performed so far.
(EN)
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Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
