Clinical Characteristics and Outcome of Patients with Situational Syncope Compared to Patients with Vasovagal Syncope

• Published in: Pacing and clinical electrophysiology 2017-05, Vol.40 (5), p.591-595
• Main Authors: WENZKE, KEVIN E., WALSH, KATHLEEN E., KALSCHEUR, MATTHEW, WASMUND, STEPHEN L., PAGE, RICHARD L., BRIGNOLE, MICHELE, HAMDAN, MOHAMED H.
• Format: Article
• Language: English
• Subjects: Adult; Cardiac arrhythmia; Cough; Defecation; Diagnosis, Differential; Female; Humans; Incidence; Male; Middle Aged; outcome; reflex; Risk Factors; situational; Symptom Assessment - statistics & numerical data; syncope; Syncope - diagnosis; Syncope - epidemiology; Syncope, Vasovagal - diagnosis; Syncope, Vasovagal - epidemiology; Tilt-Table Test - statistics & numerical data; Urination; vasovagal; Vasovagal syncope; Wisconsin - epidemiology
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.13069

Backgrounds The purpose of the study was to assess the clinical outcome of patients with situational syncope (SS) compared to patients with vasovagal syncope (VVS). Methods We assessed the prevalence, patients’ characteristics, and outcome of consecutive patients with SS and VVS who presented to the Faint and Fall Clinic (University of Wisconsin) between January 2013 and December 2015. Results SS was found in 55/1,401 (4.0%) syncope patients with follow‐up data available in 47 patients: defecation (n = 16), micturition (n = 15), cough (n = 10), swallow (n = 3), laughter (n = 1), sneeze (n = 1), and cough plus laughter (n = 1). Over the same time period, 252/1,401 patients (18%) were diagnosed with VVS with follow‐up data available in 171 patients. Compared with VVS patients, SS patients were older, more likely to be male, had a higher prevalence of hypertension, had an absence of prodromes, and experienced more injuries at the time of syncope (P = 0.01 for all). During a mean follow‐up duration of 15.4 ± 9.1 months, syncope recurred in 5/47 (10.6%) patients with SS and 16/171 (9.4%) patients with VVS. The recurrence rates at 1 year and 2 years were 20% (95% SE ± 13) and 40% (95% SE ± 20) for the SS group, and 23% (95% SE ± 13) and 43% (95% SE ± 20) for the VVS group (P = 0.6). No patient died. Conclusions We have shown in a large cohort of consecutive patients with syncope that SS is a relatively infrequent form of reflex syncope with different clinical characteristics but similar recurrence rate to VVS.