Determination of causes and therapeutic approach of cardiac syncope/presyncope Kardiyak kokenli senkop/presenkop nedenlerinin belirlenmesi ve tedavi yaklasimi


ADALET K., MERCANOĞLU F., Ozaydin M., Oflaz H., MERİÇ M., Buyukozturk K., ...More

Istanbul Tip Fakultesi Mecmuasi, vol.60, no.1, pp.50-56, 1997 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 60 Issue: 1
  • Publication Date: 1997
  • Journal Name: Istanbul Tip Fakultesi Mecmuasi
  • Journal Indexes: Scopus
  • Page Numbers: pp.50-56
  • Keywords: Presyncope, Syncope
  • Istanbul University Affiliated: Yes

Abstract

The aim of this study is to determine causes and therapeutic approach of cardiac syncope/presyncope. Group of trial was consist of 43 patients (25 men and 18 women: mean age 40.6+16 years) referred to our arrhythmia clinic for investigation of syncope/presyncope in between 1993-1995. Non-invasive (EKG, exercise testing, myocardial perfusion imaging, echocardiogram, signal averaged EKG, heart rate variability, 24-48 hour Holte monitoring, carotid sinus activity tests, atropine test, head-up tilting test) and invasive tests (hemodynamic and angiographic examination and electrophysiologic study) was used to determine the causes of cardiac syncope. Causes of syncope were tachycardia episodes resulting from WPW syndrome in 18 (42%), ventricular tachyarrhythmia in 11 (26%), vasovagal syncope in 8 (19%), atrioventriculonodal recentrant tachycardia in 2 (5%), atrial flutter in 1 (2%), and sick sinus syndrome in 1 (2%). In the retaining 2 patients, causes of syncope were not explained. Radiofrequency catheter ablation was applied to 21 (49%) patients; implantable cardioverter-defibrillator and pace-maker implanted in 3 (7%) and 1 (2%) patients respectively and 1 (2%) patients was cured surgically. Remaining patients were treated by medical therapy. In conclusion, it was convinced that detailed invasive and non - invasive methods were required to clarify causes of syncope, and that arrhythmia was an important cause in most of cases and using of non-pharmacological therapy modalities was essential.