The Role of Electrophysiologic Studies in the Management of Patients with Unexplained Syncope

We evaluated the frequency and type of electrophysiologic abnormalities in an unselected population of consecutive patients with unexplained syncope. Fifty patients were entered in the study; all had 24‐hour dynamic electrocardiographs (Holter) recordings and underwent complete electrophysiological...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 1985-05, Vol.8 (3), p.424-435
Main Authors: DENES, PABLO, EZRI, MARILYN D.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anti-Arrhythmia Agents - therapeutic use
antiarrhythmic drugs
Arrhythmias, Cardiac - physiopathology
Arrhythmias, Cardiac - therapy
Carotid Sinus - innervation
Combined Modality Therapy
Echocardiography
Electrocardiography
electrophysiology study
Exercise Test
Female
Follow-Up Studies
Heart Conduction System - physiopathology
Heart Diseases - complications
Holter recording
Humans
Male
Middle Aged
Pacemaker, Artificial
pacing
syncope
Syncope - physiopathology
Syncope - prevention & control
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Summary:We evaluated the frequency and type of electrophysiologic abnormalities in an unselected population of consecutive patients with unexplained syncope. Fifty patients were entered in the study; all had 24‐hour dynamic electrocardiographs (Holter) recordings and underwent complete electrophysiological studies. An abnormal electrophysiologic study was found in 74% of the patients. Sinus node abnormality was observed in 30%, abnormal AV node function in 14%, long HV in 10%, block distal to H during rapid atrial pacing in 6%, paroxysmal supraventricular tachycardia in 12%, ventricular tachycardialfibrillation in 8%, and hypersensitive carotid sinus syndrome in 24%. There was no correlation between Holter and electrophysiologic study findings except for the presence of paroxysmal sustained supraventricular tachycardia. Based on clinical, Holter monitoring, and electrophysiologic findings, 38% were treated by antiarrhythmic drugs, 40% received permanent pacemakers, and. 22% were not treated at all. During follow‐up (23 ± 13 months), 9 patients (18%) experienced recurrent syncope or death.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1985.tb05782.x