Long-term prognosis of patients undergoing electrophysiologic studies for syncope of unknown origin

Bass, Eric B.; Elson, James J.; Fogoros, Richard N.; Peterson, Jacqueline; Arena, Vincent C.; Kapoor, Wishwa N.

doi:10.1016/0002-9149(88)90257-3

Cited by 102 publications

(27 citation statements)

References 24 publications

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“…In particular, cardiac syncope was characterized by the worst prognosis (1) compared with the virtual absence of mortality at 12 months in the case of vasovagal events (1,3,5). It has to be noted that guidelines (2,5,21,22) and prognostic scores used in the emergency setting, aimed at stratifying patients according to risk (7,(11)(12)(13), have been derived from data at 6 or 12 months after the index event (3,11,12,19,23,24). Our data indicate that long-and shortterm risk factors are significantly different.…”

Section: Adverse Short-term Events In Admitted and Discharged Patientsmentioning

confidence: 83%

Short- and Long-Term Prognosis of Syncope, Risk Factors, and Role of Hospital Admission

Costantino

Perego

Dipaola

et al. 2008

Journal of the American College of Cardiology

238

207

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Section: Adverse Short-term Events In Admitted and Discharged Patientsmentioning

confidence: 83%

Short- and Long-Term Prognosis of Syncope, Risk Factors, and Role of Hospital Admission

Costantino

Perego

Dipaola

et al. 2008

Journal of the American College of Cardiology

238

207

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“…Bass et al studied 37 patients with positive EPS for unexplained syncope (3 1 with inducible VT), and at 3 years the sudden cardiac death rate in this population was 48%. 23 Similarly, Click et ul. reported a sudden cardiac death rate of 24% in 46 patients with inducible VT at EPS for unexplained syncope in the presence of bundle-branch block on surface ECG.…”

Section: Role Of Electrophysiologic Stimulationmentioning

confidence: 97%

Implantable cardioverter defibrillator discharge rates in patients with unexplained syncope, structural heart disease, and inducible ventricular tachycardia at electrophysiologic study

Menon

Steinberg

Akiyama

et al. 2000

Clinical Cardiology

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SummaryBuckground and hypothesis: The implantable cardioverter defibrillator (ICD) is the best available strategy to protect patients from life-threatening ventricular arrhythmia. Although unproven, it is commonly utilized to treat subjects with syncope, a negative clinical workup, structural heart disease, and inducible sustained monomorphic ventricular tachycardia (VT) on programmed electrophysiologic stimulation (EPS). The purpose of this paper was to validate this approach.Methods: We retrospectively identified 36 subjects who received primary ICD therapy for syncope in the setting of structural heart disease with inducible sustained monomorphic VT on EPS. The cohort was predominantly male (32/36) with underlying coronary artery disease (29/36). The mean left ventricular ejection fraction was 3 1 12%, and a third of the patients ( I 2/36) had undergone bypass surgery.Results: The study group was followed for a mean of 23 & 15 months (range 3-81 months) and experienced an ICD event rate of 22% at 3 months, which increased to 55% at 36 months. This event rate was comparable with the 66% event rate seen in a group of patients with primary ICD therapy for spontaneous life-threatening VT treated during the same time period. No future predictors of ICD events in the study group could be identified.Conclusion: Syncope patients with negative workup, structural heart disease, and sustained monomorphic VT at EPS are at high risk for future tachyarrhythmic events. Based on present evidence, primary ICD therapy in this group appears warranted and justified.

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“…Syncope is a transient symptom that may be caused by an underlying rhythm disorder with or without an associated cardiac disease. EP testing is used to document or exclude the arrhythmic cause of syncope (120,211). It is most useful in patients with CHD and LV dysfunction.…”

Section: Electrophysiological Testing In Patients With Outflow Tract mentioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Zipes¹,

Camm²,

Borggrefe³

et al. 2006

Circulation

1,206

671

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Long-term prognosis of patients undergoing electrophysiologic studies for syncope of unknown origin

Cited by 102 publications

References 24 publications

Short- and Long-Term Prognosis of Syncope, Risk Factors, and Role of Hospital Admission

Short- and Long-Term Prognosis of Syncope, Risk Factors, and Role of Hospital Admission

Implantable cardioverter defibrillator discharge rates in patients with unexplained syncope, structural heart disease, and inducible ventricular tachycardia at electrophysiologic study

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

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