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Tolga Aksu, Tumer Erdem Guler, Kivanc Yalin, Ferit Onur Mutluer, Kazim Serhan Ozcan, Leonardo Calò
Enhanced parasympathetic tone may cause sinus bradycardia or pauses, transient or permanent atrioventricular block, with resultant vasovagal syncope. A substantial portion of these patients may be highly symptomatic and refractory to the conventional therapies and may require cardiac pacemaker implantation. Cardioneuroablation is a little known technique for management of patients with excessive vagal activation based on radiofrequency catheter ablation of main parasympathetic autonomic ganglia around the heart...
March 2018: American Journal of the Medical Sciences
Andrew P Owens, David A Low, Hugo D Critchley, Christopher J Mathias
Cognitive and emotional processes are influenced by interoception (homeostatic somatic feedback), particularly when physiological arousal is unexpected and discrepancies between predicted and experienced interoceptive signals may engender anxiety. Due to the vulnerability for comorbid psychological symptoms in forms of orthostatic intolerance (OI), this study investigated psychophysiological contributions to emotional symptomatology in 20 healthy control participants (13 females, mean age 36 ± 8 years), 20 postural tachycardia syndrome (PoTS) patients (18 females, mean age 38 ± 13 years) and 20 vasovagal syncope (VVS) patients (15 females, mean age 39 ± 12 years)...
January 31, 2018: Autonomic Neuroscience: Basic & Clinical
R B Guimarães, V Essebag, M Furlanetto, J P G Yanez, M G Farina, D Garcia, E D Almeida, L Stephan, G G Lima, T L L Leiria
We described the clinical evolution of patients with structural heart disease presenting at the emergency room with syncope. Patients were stratified according to their syncope etiology and available scores for syncope prognostication. Cox proportional hazard models were used to investigate the relationship between etiology of the syncope and event-free survival. Of the 82,678 emergency visits during the study period, 160 (0.16%) patients were there due to syncope, having a previous diagnosis of structural heart disease...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Kyriaki Kostoglou, Ronald Schondorf, Julie Benoit, Saharnaz Balegh, Georgios D Mitsis
OBJECTIVE: In this study we aimed to predict the time to syncope occurrence (TSO) in patients with vasovagal syncope (VVS), solely based on measurements recorded during the supine position of the head-up tilt (HUT) testing protocol. METHODS: We extracted various time and frequency domain features related to morphological aspects of arterial blood pressure (ABP) and the electrocardiogram (ECG) raw signals as well as to dynamic interactions between beat-to-beat ABP, heart rate, and cerebral blood flow velocity...
2018: Acta Neurochirurgica. Supplement
Kathleen E Walsh, Trisha Baneck, Richard L Page, Michele Brignole, Mohamed H Hamdan
BACKGROUND: Psychogenic pseudo-syncope (PPS) frequently mimics syncope. The aim of this study was to assess the prevalence and clinical features of PPS and its relationship to vasovagal syncope (VVS). METHODS: We examined retrospectively the medical records of 1401 consecutive patients referred to a syncope unit. We identified patients who had the final diagnosis of PPS. In these patients, we retrieved the initial diagnosis made during their first visit and the subsequent tests performed leading to the final diagnosis...
February 24, 2018: Pacing and Clinical Electrophysiology: PACE
Pietro Palmisano, Matteo Ziacchi, Mauro Biffi, Renato P Ricci, Maurizio Landolina, Massimo Zoni-Berisso, Eraldo Occhetta, Giampiero Maglia, Gianluca Botto, Luigi Padeletti, Giuseppe Boriani
: The purpose of this two-part consensus document is to provide specific suggestions (based on an extensive literature review) on appropriate pacemaker setting in relation to patients' clinical features. In part 2, criteria for pacemaker choice and programming in atrioventricular blocks and neurally mediate syncope are proposed. The atrioventricular blocks can be paroxysmal or persistent, isolated or associated with sinus node disease. Neurally mediated syncope can be related to carotid sinus syndrome or cardioinhibitory vasovagal syncope...
February 20, 2018: Journal of Cardiovascular Medicine
Abigail Louise D Te, Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Fa-Po Chung, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Yao-Ting Chang, Chin-Yu Lin, Shinya Yamada, Ting-Yung Chang, Simon Salim, Minh Quang Hoang, Ting-Chun Huang, Shih-Ann Chen
BACKGROUND: Vasovagal responses (VR) encountered during radiofrequency pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF) suggest ablation of the atrial tissue subjacent to the ganglionic plexi (GP) and confer durability of PVI. OBJECTIVE: We hypothesized that VR during cryoballoon PVI (CB-PVI) in PAF can predict mid-term AF recurrence. METHODS: We enrolled 39 patients who underwent PVI using 2nd generation cryoballoon for PAF from November 2014 to July 2016...
January 31, 2018: International Journal of Cardiology
Gonzalo Barón-Esquivias, Carlos A Morillo, Angel Moya-Mitjans, Jesús Martínez-Alday, Ricardo Ruiz-Granell, Javier Lacunza-Ruiz
No abstract text is available yet for this article.
March 2018: Revista Española de Cardiología
Foluke A Fasola
The existence and sustenance of the blood bank depends on blood donors. It is imperative that the donation experience is satisfactory for the donors. Therefore this study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance. This was a retrospective descriptive study of the events that occurred amongst the blood donors of the blood bank of a tertiary institution. The blood donor incident book was reviewed for the period of six months...
December 31, 2017: Journal of Public Health in Africa
Konstantinos A Gatzoulis, Dimitris Tousoulis
No abstract text is available yet for this article.
February 3, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Li He, Lan Wang, Lun Li, Xiaoyan Liu, Yijun Yu, Xiaoyun Zeng, Huanhuan Li, Ye Gu
Non-pharmacological therapies, especially the physical maneuvers, are viewed as important and promising strategies for reducing syncope recurrences in vasovagal syncope (VVS) patients. We observed the efficacy of a modified Valsalva maneuver (MVM) in VVS patients. 72 VVS patients with syncope history and positive head-up tilt table testing (HUTT) results were randomly divided into conventional treatment group (NVM group, n = 36) and conventional treatment plus standard MVM for 30 days group (MVM group, n = 36)...
2018: PloS One
Wenbo He, Xiaoying Wang, Shan Liu, Xiaomei Yu, Zhibing Lu, Ruisong Ma, Da Luo, Jing Xie, Bo He, Hong Jiang
PURPOSE: Individuals predisposed to vasovagal syncope may have different autonomic nervous system control mechanisms from those without predisposition to vasovagal events. To test this hypothesis, we investigated different sympathetic responses in a canine model of vasovagal syncope. METHODS: Left thoracotomy was performed on 20 mongrel dogs. The heart was exposed and a bolus of veratridine (15 μg/kg), a neurotoxin which prevents the inactivation of sodium ion channels, was injected into the left atrium to induce a Bezold-Jarisch reflex-mediated vasovagal event, characterized by bradycardia, decreased inotropism, and hypotension...
January 24, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Y Liao, J B Du
No abstract text is available yet for this article.
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
(no author information available yet)
No abstract text is available yet for this article.
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Andrew P Owens, Karl J Friston, David A Low, Christopher J Mathias, Hugo D Critchley
Predictive coding models, such as the 'free-energy principle' (FEP), have recently been discussed in relation to how interoceptive (afferent visceral feedback) signals update predictions about the state of the body, thereby driving autonomic mediation of homeostasis. This study appealed to 'interoceptive inference', under the FEP, to seek new insights into autonomic (dys)function and brain-body integration by examining the relationship between cardiac interoception and autonomic cardiac control in healthy controls and patients with forms of orthostatic intolerance (OI); to (i) seek empirical support for interoceptive inference and (ii) delineate if this relationship was sensitive to increased interoceptive prediction error in OI patients during head-up tilt (HUT)/symptom provocation...
January 9, 2018: Autonomic Neuroscience: Basic & Clinical
Stavros Stavrakis, Sunny Po
Ganglionated plexi (GP), consisting of conglomerations of autonomic ganglia on the epicardial surface of the heart, have been shown to play a significant role in different arrhythmias, including atrial fibrillation. GP ablation has become an adjunctive procedure in the treatment of atrial fibrillation, while it has been used successfully in preliminary studies in vasovagal syncope. This review will present the current data on the physiology and clinical applications of GP ablation in the treatment of atrial fibrillation and other diseases...
December 2017: Arrhythmia & Electrophysiology Review
Marie H Bernardo, Satish R Tiyyagura
BACKGROUND Brugada pattern on electrocardiogram (ECG) is seen when there are at least 2 mm J-point elevation and 1 mm ST-segment elevation in two or more of the right precordial leads, with right bundle-branch block (RBBB)-like morphology. Elevation of a coved-type shape in leads V1 and V2 is consistent with type I Brugada pattern, whereas elevation of a saddle-back configuration distinguishes type II Brugada. If accompanied by life-threatening arrhythmias or sudden cardiac death, Brugada syndrome (BrS) is diagnosed...
January 5, 2018: American Journal of Case Reports
Rainer Spiegel, Mark Kirsch, Christiane Rosin, Heiko Rust, Thomas Baumann, Raoul Sutter, Hergen Friedrich, Martina Göldlin, René Müri, Roger Kalla, Roland Bingisser, Georgios Mantokoudis
This review aims to assist emergency physicians in finding the underlying aetiology when a patient presents with dizziness to the emergency department. After reading this review, the emergency physician will be able to consider the most relevant differential diagnoses and have an idea about dangerous aetiologies that require immediate action. The emergency physician will also know what diagnostic steps need to be taken at what time, such as the three-component HINTS Test (Head Impulse, Nystagmus, and Test-of-Skew), which helps with distinguishing central from peripheral causes of the acute vestibular syndrome...
December 28, 2017: Swiss Medical Weekly
Kimberly A Christensen, Barbara J Gosse, Celia Hildebrand, Lynn A Gershan
Background: Vasovagal responses associated with acupuncture therapy are relatively uncommon adverse events, occurring in ∼0.02%-7% of treatments. The complex neurocardiovascular reflexes involved in vasovagal responses can induce a range of symptoms such as dizziness, nausea, sweating, bradycardia, hypotension, and, in some cases, syncope or convulsions. Although patients typically recover quickly with proper support, these events may be of concern and anxiety-producing for both patient and provider. Providers need to be well-versed in methods for prevention and treatment of acupuncture-associated vasovagal responses to promote safe practice environments, patient satisfaction and comfort, and cost-effectiveness...
December 1, 2017: Medical Acupuncture
Valentina De Regibus, Darragh Moran, Gian Battista Chierchia, Pedro Brugada, Carlo de Asmundis
Vasovagal syncope is characterized by vasodilatation and/or bradycardia and thereby a fall in arterial BP and global cerebral perfusion in response to a trigger. Although it is a benign condition, patients with frequent and traumatic episodes need treatment in order to improve quality of life. We describe the case of a 17-years-old boy suffering from cardioinhibitory syncope. At the end of a complete negative cardiac and neurological examination, a loop recorder was implanted. During the subsequent follow-up the ILR documented a 9-s pause...
December 21, 2017: Indian Pacing and Electrophysiology Journal
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