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Vasovagal syncope

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https://www.readbyqxmd.com/read/29470251/clinically-oriented-device-programming-in-bradycardia-patients-part-2-atrioventricular-blocks-and-neurally-mediated-syncope-proposals-from-aiac-italian-association-of-arrhythmology-and-cardiac-pacing
#1
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
https://www.readbyqxmd.com/read/29422268/selection-of-the-best-of-2017-on-the-usefulness-of-cardiac-stimulation-in-the-treatment-of-vasovagal-syncope
#2
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.
February 5, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29381726/a-single-center-randomized-controlled-trial-observing-the-safety-and-efficacy-of-modified-step-up-graded-valsalva-manoeuver-in-patients-with-vasovagal-syncope
#3
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
https://www.readbyqxmd.com/read/29368225/sympathetic-mechanisms-in-an-animal-model-of-vasovagal-syncope
#4
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
https://www.readbyqxmd.com/read/29342990/-intensive-reading-and-interpretation-of-the-expert-consensus-on-the-treatment-of-vasovagal-syncope-and-postural-tachycardia-syndrome-in-children
#5
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
https://www.readbyqxmd.com/read/29342989/-expert-consensus-on-the-treatment-of-vasovagal-syncope-and-postural-tachycardia-syndrome-in-children
#6
(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
https://www.readbyqxmd.com/read/29331491/investigating-the-relationship-between-cardiac-interoception-and-autonomic-cardiac-control-using-a-predictive-coding-framework
#7
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
https://www.readbyqxmd.com/read/29326833/ganglionated-plexi-ablation-physiology-and-clinical-applications
#8
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
https://www.readbyqxmd.com/read/29302023/a-case-of-type-i-and-ii-brugada-phenocopy-unmasked-in-a-patient-with-normal-baseline-electrocardiogram-ecg
#9
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
https://www.readbyqxmd.com/read/29282699/dizziness-in-the-emergency-department-an-update-on-diagnosis
#10
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
https://www.readbyqxmd.com/read/29279731/acupuncture-associated-vasovagal-response-revised-terminology-and-hospital-experience
#11
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
https://www.readbyqxmd.com/read/29274799/leadless-pacing-in-a-young-patient-with-cardioinhibitory-vasovagal-syncope
#12
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
https://www.readbyqxmd.com/read/29246828/pathophysiology-of-the-vasovagal-response
#13
David L Jardine, Wouter Wieling, Michele Brignole, Jacques W M Lenders, Richard Sutton, Julian Stewart
In part I of this study, we found that the classical studies on vasovagal syncope, conducted in fit young subjects, overstated vasodilatation as the dominant hypotensive mechanism. Since 1980, blood pressure and cardiac output have been measured continuously using noninvasive methods during tilt, mainly in patients with recurrent syncope, including women and the elderly. This has allowed us to analyze in more detail the complex sequence of hemodynamic changes leading up to syncope in the laboratory. All tilt-sensitive patients appear to progress through 4 phases: (1) early stabilization, (2) circulatory instability, (3) terminal hypotension, and (4) recovery...
December 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29240992/heart-rate-recovery-and-diastolic-blood-pressure-ratio-on-the-treadmill-test-predict-an-induction-and-recurrence-of-vasovagal-syncope
#14
Yu Jeong Choi, Ki-Woon Kang, Sang Hyun Jang, Jae Guk Kim, Soo Joo Lee, Kyung Tea Jung
Background/Aims: The induction and recurrence of syncope is a concerning situation that could be unpredicted in the vasovagal syncope (VVS). We investigated a simple predictor for the induced and recurrent VVS during Head-Up table-tilt Test (HUT) and clinically follow-up. Methods: The 143 consecutive patients with VVS (age 31 ± 19 years, 33 male) who referred by a cardiologist or neurologist and had undergone an echocardiogram, HUT, and a treadmill exercise test (TMT) were recruited and clinically follow-up...
December 18, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29240320/time-has-not-passed-for-the-tilt-table-test
#15
Jani Pirinen, Markku Walamies
INTRODUCTION: The tilt table test is used for determining the loss of consciousness, and in the case of reflex syncope, for gaining insight into the circulatory mechanism. In 2015, all tilt tests within the Hospital District of Helsinki and Uusimaa (HUS) were performed in the clinical physiology unit of the HUS Medical Imaging Center at Peijas Hospital. METHODS: The patients' medical history, circulation monitor printouts, and medical reports were recorded from all tilt tests carried out during 2015...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29229215/atrial-fibrillation-neurogenic-or-myogenic
#16
REVIEW
Alina Scridon, Răzvan Constantin Şerban, Philippe Chevalier
A 55-year-old hypertensive patient presents atrial fibrillation after vasovagal syncope. Non-invasive cardiac workup is normal. Without antiarrhythmic therapy, the patient has no recurrence for the next 3years, then presents with a stroke. Echocardiography eventually reveals left atrial dilation. This sequence of events illustrates the well-known links between age, arterial hypertension, atrial fibrillation, atrial neuromyopathy and stroke. A frequently neglected common denominator in this equation is impaired sympathovagal balance...
December 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29222896/serum-vitamin-b-12-in-children-presenting-with-vasovagal-syncope
#17
Ayhan Pektas, Resit Koken, Halit Bugra Koca
BACKGROUND AND OBJECTIVES: The present study aims to determine the serum vitamin B-12 in children presenting with vasovagal syncope. METHODS AND STUDY DESIGN: This is a prospective review of 160 children presenting with vasovagal syncope. Subgroup analysis was done based on the results of head up tilt test. RESULTS: Head up tilt test gave positive results in 80 children and yielded negative results in the remaining 80 children. The tilt test positive children had significantly lower thyroid stimulating hormone concentrations (p=0...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29222399/pediatric-disorders-of-orthostatic-intolerance
#18
REVIEW
Julian M Stewart, Jeffrey R Boris, Gisela Chelimsky, Phillip R Fischer, John E Fortunato, Blair P Grubb, Geoffrey L Heyer, Imad T Jarjour, Marvin S Medow, Mohammed T Numan, Paolo T Pianosi, Wolfgang Singer, Sally Tarbell, Thomas C Chelimsky
Orthostatic intolerance (OI), having difficulty tolerating an upright posture because of symptoms or signs that abate when returned to supine, is common in pediatrics. For example, ∼40% of people faint during their lives, half of whom faint during adolescence, and the peak age for first faint is 15 years. Because of this, we describe the most common forms of OI in pediatrics and distinguish between chronic and acute OI. These common forms of OI include initial orthostatic hypotension (which is a frequently seen benign condition in youngsters), true orthostatic hypotension (both neurogenic and nonneurogenic), vasovagal syncope, and postural tachycardia syndrome...
January 2018: Pediatrics
https://www.readbyqxmd.com/read/29210724/anesthetic-management-of-a-pacemaker-with-a-rate-drop-response-setting-a-case-report
#19
Alex K Saltzman, Peter J Fu, Brian Egan
Permanent pacemakers are used for a variety of conditions and are commonly encountered in the perioperative period. This report describes the anesthetic management of a patient with a permanent pacemaker with a rate drop response (RDR) who presented for a laparoscopic left adrenalectomy. The RDR setting is a novel pacemaker mode often used in patients with a history of vasovagal syncope. There are no previous reports describing the anesthetic management of such a pacemaker. This case report describes the features of the RDR setting with the goal of educating clinicians who may encounter patients with this type of pacemaker...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29189552/autonomic-reflex-screen-test-abnormalities-in-cold-induced-sweating-syndrome-type-1
#20
Ahmed M El-Dokla, Jannatul Ferdous, Sara T Ali, Khondoker Alam
Cold-induced sweating syndrome (CISS) is a rare autosomal recessive disease due to mutation in the Cytokine receptor-like factor 1 (CRLF1). The characteristic symptom of CISS is the tendency to sweat profusely especially in the upper body and hands when the patient is exposed to cold temperature. We sought to first report the findings of autonomic reflex screen in a case of CISS type 1 with Cytokine receptor-like factor 1 mutation. Valsalva morphology, Valsalva ratio, and heart rate response to deep breathing were normal for the patient's age...
December 2017: Journal of Clinical Neuromuscular Disease
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