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Cardiology Clinics Aug 2015Most strategies for managing syncope in children reflect data from studies involving the adult population. In the future, there will be a great need for studies in... (Review)
Review
Most strategies for managing syncope in children reflect data from studies involving the adult population. In the future, there will be a great need for studies in children and adolescents suffering from recurrent syncope. To date, there has been no Food and Drug Administration-approved therapy for neurocardiogenic syncope (NCS), the most common cause of syncope in both adults and children. None of the clinical trials of pharmacotherapy in NCS has shown benefit over placebo. NCS should be considered a chronic condition, and the aim of the therapy should be to decrease recurrence of syncope rather than to completely eliminate it.
Topics: Adolescent; Child; Disease Management; Humans; Incidence; Recurrence; Syncope, Vasovagal; Tilt-Table Test
PubMed: 26115826
DOI: 10.1016/j.ccl.2015.04.008 -
Autonomic Neuroscience : Basic &... Nov 2021Vasovagal syncope may have a genetic predisposition. It has a high prevalence in some families, and children of a fainting parent are more likely to faint than those...
Vasovagal syncope may have a genetic predisposition. It has a high prevalence in some families, and children of a fainting parent are more likely to faint than those without a parent who faints. Having two fainting parents or a fainting twin increases the likelihood even further. Several genotypes appear to associate with the phenotype of positive tilt tests, but the control subjects are usually those who faint and have negative tilt tests. Twin studies, highly focused genome-wide association studies, and copy number variation studies all suggest there are loci in the genome that associate with vasovagal syncope, although the specific genes, pathways, and proteins are unknown. A recent multigenerational kindred candidate gene study identified 3 genes that associate with vasovagal syncope. The best evidence to date is for central signaling genes involving serotonin and dopamine. Genome-wide association studies to date have not yet been helpful. Our understanding of the genetic correlates of vasovagal syncope leaves ample opportunity for future work.
Topics: DNA Copy Number Variations; Genetic Markers; Genome-Wide Association Study; Humans; Syncope, Vasovagal; Tilt-Table Test
PubMed: 34474354
DOI: 10.1016/j.autneu.2021.102871 -
European Heart Journal Jun 2022Unexplained syncope is an important clinical challenge. The influence of age at first syncope on the final syncope diagnosis is not well studied.
AIMS
Unexplained syncope is an important clinical challenge. The influence of age at first syncope on the final syncope diagnosis is not well studied.
METHODS AND RESULTS
Consecutive head-up tilt patients (n = 1928) evaluated for unexplained syncope were stratified into age groups <30, 30-59, and ≥60 years based on age at first syncope. Clinical characteristics and final syncope diagnosis were analysed in relation to age at first syncope and age at investigation. The age at first syncope had a bimodal distribution with peaks at 15 and 70 years. Prodromes (64 vs. 26%, P < 0.001) and vasovagal syncope (VVS, 59 vs. 19%, P < 0.001) were more common in early-onset (<30 years) compared with late-onset (≥60 years) syncope. Orthostatic hypotension (OH, 3 vs. 23%, P < 0.001), carotid sinus syndrome (CSS, 0.6 vs. 9%, P < 0.001), and complex syncope (>1 concurrent diagnosis; 14 vs. 26%, P < 0.001) were more common in late-onset syncope. In patients aged ≥60 years, 12% had early-onset and 70% had late-onset syncope; older age at first syncope was associated with higher odds of OH (+31% per 10-year increase, P < 0.001) and CSS (+26%, P = 0.004). Younger age at first syncope was associated with the presence of prodromes (+23%, P < 0.001) and the diagnoses of VVS (+22%, P < 0.001) and complex syncope (+9%, P = 0.018).
CONCLUSION
In patients with unexplained syncope, first-ever syncope incidence has a bimodal lifetime pattern with peaks at 15 and 70 years. The majority of older patients present only recent syncope; OH and CSS are more common in this group. In patients with early-onset syncope, prodromes, VVS, and complex syncope are more common.
Topics: Humans; Hypotension, Orthostatic; Incidence; Syncope; Syncope, Vasovagal; Tilt-Table Test
PubMed: 35139180
DOI: 10.1093/eurheartj/ehac017 -
Heart (British Cardiac Society) Dec 2023
Topics: Humans; Syncope, Vasovagal; Bradycardia; Heart Rate; Tilt-Table Test
PubMed: 37591689
DOI: 10.1136/heartjnl-2023-323180 -
Transfusion Apr 2022People with needle fear experience not only anxiety and stress but also vasovagal reactions (VVR), including nausea, dizziness, sweating, pallor changes, or even...
BACKGROUND
People with needle fear experience not only anxiety and stress but also vasovagal reactions (VVR), including nausea, dizziness, sweating, pallor changes, or even fainting. However, the mechanism behind needle fear and the VVR response are not yet well understood. The aim of our study was to explore whether fluctuations in facial temperature in several facial regions are related to the level of experienced vasovagal reactions, in a simulated blood donation.
STUDY DESIGN AND METHODS
We recruited 45 students at Tilburg University and filmed them throughout a virtual blood donation procedure using an Infrared Thermal Imaging (ITI) camera. Participants reported their fear of needles and level of experienced vasovagal reactions. ITI data pre-processing was completed on each video frame by detecting facial landmarks and image alignment before extracting the mean temperature from the six regions of interest.
RESULTS
Temperatures of the chin and left and right cheek areas increased during the virtual blood donation. Mixed-effects linear regression showed a significant association between self-reported vasovagal reactions and temperature fluctuations in the area below the nose.
DISCUSSION
Our results suggest that the area below the nose may be an interesting target for measuring vasovagal reactions using video imaging techniques. This is the first in a line of studies, which assess whether it is possible to automatically detect levels of fear and vasovagal reactions using facial imaging, from which the development of e-health solutions and interventions can benefit.
Topics: Blood Donors; Fear; Humans; Phobic Disorders; Syncope; Syncope, Vasovagal
PubMed: 35191034
DOI: 10.1111/trf.16832 -
Journal of Cardiovascular Medicine... Feb 2021It is commonly reported that vasovagal syncope (VVS) is more frequent in women. Presently, this issue has never been investigated. The purpose of this review was to... (Review)
Review
It is commonly reported that vasovagal syncope (VVS) is more frequent in women. Presently, this issue has never been investigated. The purpose of this review was to evaluate, through an extensive review of the literature, whether women are really more affected by VVS than men. The gender distribution was investigated in individuals with classical and nonclassical VVS. The database PubMed was searched using the terms 'syncope', 'vasovagal syncope', 'neurally mediated syncope' and 'tilt testing'. Twelve studies dealing with classical and 75 with nonclassical VVS were eligible. In the individuals with classical (N = 1861) and nonclassical VVS (N = 9696), a trend towards a greater percentage of women emerged (P = 0.14 and 0.07, respectively). In the total population with VVS (N = 11 557), the percentage of women was significantly higher than that of men (58 versus 42%, P = 0.03). Most of the individuals were young or middle-aged. In 84% of the studies, the percentage of women was greater than that of men. A separate analysis was carried out in older VVS patients (≥60 years) and only two studies were eligible to be evaluated. Considering that almost all the studies were carried out in the western nations, where the number of men and women is almost superimposable until the age of 65 years and a bias by gender has never been reported in the management of VVS, these data strongly suggest that young and middle-aged women are more affected by VVS than their male counterparts. At present, data are too scant to draw a definitive conclusion in older VVS patients.
Topics: Female; Global Health; Humans; Male; Prevalence; Sex Distribution; Sex Factors; Syncope, Vasovagal; Tilt-Table Test
PubMed: 32925389
DOI: 10.2459/JCM.0000000000001009 -
Clinical Pediatrics Oct 2014
Topics: Child; Electrocardiography; Female; Humans; Recurrence; Syncope, Vasovagal
PubMed: 24951556
DOI: 10.1177/0009922814540044 -
International Journal of Cardiology Jul 2021
Topics: Cardiac Pacing, Artificial; Humans; Sick Sinus Syndrome; Syncope, Vasovagal
PubMed: 33940095
DOI: 10.1016/j.ijcard.2021.04.050 -
Autonomic Neuroscience : Basic &... Dec 2021It is well known that the autonomic nervous system (ANS) is a major contributor in etiopathogenesis of vasovagal syncope (VVS). Catheter based neuromodulation (CNA) of... (Review)
Review
It is well known that the autonomic nervous system (ANS) is a major contributor in etiopathogenesis of vasovagal syncope (VVS). Catheter based neuromodulation (CNA) of the intrinsic cardiac ANS has evolved rapidly from being an experimental unproven procedure to its current status as an increasingly performed ablation procedure in many major hospitals worldwide. The present review aims to bring the anatomical elements of intrinsic cardiac ANS and clinical application of intrinsic cardiac neuromodulation together, by reviewing anatomical terminologies and clinical data, in order to provide a practical assistance to the electrophysiology community.
Topics: Brain; Catheter Ablation; Heart; Heart Rate; Humans; Syncope, Vasovagal; Vagus Nerve
PubMed: 34666205
DOI: 10.1016/j.autneu.2021.102892 -
Clinical Autonomic Research : Official... Oct 2020
Topics: Humans; Syncope, Vasovagal
PubMed: 32300948
DOI: 10.1007/s10286-020-00689-y