Diagnosis of Neurally Mediated Syncope: Might Use of the Implantable Loop Recorder Replace the Tilt-table Test? A Positive View

2004 ◽  
pp. 595-598
Author(s):  
A. Moya
Keyword(s):  
Implantable Loop Recorder ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Loop Recorder ◽  
Positive View ◽  
Neurally Mediated Syncope

The Use of Transcranial Doppler during Tilt Table Testing in Children Presenting with Syncope

2007 ◽  
Vol 31 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Heather A. Nicoletto ◽  
Mark W. Ellis ◽  
Daniel T. Laskowitz ◽  
Ronald J. Kanter ◽  
April E. Perry ◽  
...  
Keyword(s):  
Transcranial Doppler ◽  
Psychiatric Treatment ◽  
Cerebral Arteries ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Multimodal Monitoring ◽  
Neurally Mediated Syncope ◽  
Middle Cerebral Arteries ◽  
Tilt Table Testing ◽  
Flow Velocities

Childhood syncope is common, and there are three categories of causes of syncope: noncardiovascular pseudosyncope, cardiovascular syncope, and neurally mediated syncope. Tilt table testing has become a valuable tool in the evaluation for the cause of syncope in children. Adding transcranial Doppler (TCD) to the tilt table test to monitor the middle cerebral arteries (MCA) adds valuable information about the cerebral blood flow during a syncopal episode and can help the physician differentiate between the various causes of syncope. Three children with frequent syncopal episodes were evaluated using tilt table testing with multimodal monitoring, including TCD. One child, during her syncopal episode, had an increase in blood pressure, heart rate, and MCA flow velocities. This finding was consistent with noncardiovascular pseudosyncope, and she was sent for psychiatric treatment. The other two patients had hypotension, bradycardia, a significant decrease in MCA flow velocities, and an increase in pulsatility indices. Additionally, one of them experienced a 6-sec period of asystole. Both were diagnosed with neurally mediated syncope and were placed on fludrocortisone and a water and salt regimen.

Hormonal Responses During Tilt-Table Test in Neurally Mediated Syncope

1997 ◽  
Vol 79 (12) ◽  
pp. 1692-1695 ◽  
Author(s):  
George N. Theodorakis ◽  
Manolis Markianos ◽  
Efthimios G. Livanis ◽  
Elias Zarvalis ◽  
Panagiota Flevari ◽  
...  
Keyword(s):  
Tilt Table Test ◽  
Tilt Table ◽  
Hormonal Responses ◽  
Neurally Mediated Syncope

scholarly journals The benefit of pacemaker therapy in patients with neurally mediated syncope and documented asystole: a meta-analysis of implantable loop recorder studies

EP Europace ◽  
2017 ◽  
Vol 20 (8) ◽  
pp. 1362-1366 ◽  
Author(s):  
Michele Brignole ◽  
Jean Claude Deharo ◽  
Carlo Menozzi ◽  
Angel Moya ◽  
Richard Sutton ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Implantable Loop Recorder ◽  
Loop Recorder ◽  
Pacemaker Therapy ◽  
Neurally Mediated Syncope

scholarly journals Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope

2006 ◽  
Vol 27 (9) ◽  
pp. 1085-1092 ◽  
Author(s):  
Michele Brignole ◽  
Richard Sutton ◽  
Carlo Menozzi ◽  
Roberto Garcia-Civera ◽  
Angel Moya ◽  
...  
Keyword(s):  
Implantable Loop Recorder ◽  
Specific Therapy ◽  
Loop Recorder ◽  
Early Application ◽  
Neurally Mediated Syncope

scholarly journals Electrocardiographic Patterns in Patients with Neurally Mediated Syncope

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 808
Author(s):  
Călina-Patricia Țentea ◽  
Csilla-Andrea Eötvös ◽  
Roxana-Daiana Lazar ◽  
Giorgia Paștiu ◽  
Iulia-Georgiana Zehan ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Ecg Monitoring ◽  
Tilt Table Test ◽  
Ecg Changes ◽  
Tilt Table ◽  
Neurally Mediated Syncope ◽  
Electrocardiogram Ecg ◽  
Selection Of Patients ◽  
Diagnostic And Prognostic Value ◽  
Selection Of

The baseline electrocardiogram (ECG) is less informative in neurally mediated syncope (NMS) than in arrhythmic syncope. However, some of the ECG patterns present in NMS can have diagnostic and prognostic value in such patients. Electrocardiographic documentation of a syncopal spell and thus identification of the ECG changes can be performed during tilt table test (TTT) or during prolonged ECG monitoring. This work reviews the specific ECG patterns in NMS, which are primarily related to the cardioinhibitory reflex. In addition, there are other ECG findings present in patients with NMS that are being analyzed, such as increased heart rate variability as well as specific QRS voltage patterns. In addition to the diagnostic and prognostic value, these ECG patterns in NMS may help improving the selection of patients for pacemaker implant.

Evaluation of a Single Stage Nitroglycerin Tilt Table Test for Diagnosis of Neurally Mediated Syncope

2001 ◽  
Vol 24 (10) ◽  
pp. 1494-1499 ◽  
Author(s):  
CHUNYU ZENG ◽  
GUANGYAO LIU ◽  
CHENGMING YANG ◽  
WEI SUN ◽  
YIELI WANG ◽  
...  
Keyword(s):  
Single Stage ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Neurally Mediated Syncope

The Implantable Loop Recorder

2006 ◽  
Vol 0 (2) ◽  
pp. 61
Author(s):  
Richard Sutton ◽  
Michele Brignole ◽  
◽  
Keyword(s):  
Implantable Loop Recorder ◽  
Loop Recorder

Role of implantable loop recorder in the clinical diagnosis of syncope: Results of the introduction of an effective diagnostic tool

2015 ◽  
Vol 156 (15) ◽  
pp. 609-613
Author(s):  
Miklós Somlói ◽  
Emil Toldy-Schedel ◽  
Zoltán Nényei ◽  
Róbert Böszörményi ◽  
János Tomcsányi
Keyword(s):  
Clinical Practice ◽  
Diagnostic Yield ◽  
Diagnostic Algorithm ◽  
Definitive Treatment ◽  
Implantable Loop Recorder ◽  
Everyday Clinical Practice ◽  
Loop Recorder ◽  
Early Application ◽  
Electrocardiographic Monitoring ◽  
The Everyday

Introduction: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. Aim: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. Method: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. Results: There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. Conclusions: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope. Orv. Hetil., 2015, 156(15), 609–613.

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