Emerging Risk Stratification in Syncope.

The first Guidelines of European Society of Cardiology (ESC) for the management of syncope, were published in 2001, and later reviewed in 2004 (1). In March 2008, the ESC Committee for Practice Guidelines considered that there were enough new data to justify production of new guidelines. It recognised the need to produce a comprehensive document that is addressed not only to cardiologists but to all physicians who are interested in the field. In new guidelines two distinct reasons for evaluating patients with syncope were defined: one is to identify the precise cause in order to address an effective mechanism-specific treatment and the other is to identify the specific risk to the patient. At that time there was enough evidence contributing in favour that risk often depends on the underlying disease rather than on the mechanism of syncope itself (2). The aim for new guidelines was to provide sufficient background for physicians to avoid confounding these two vitally important concepts in management of patients with syncope. To achieve this aim a great number of specialists were involved, as either full members of ESC, external contributors or reviewers nominated by international societies of neurology, autonomic disease, internal medicine, emergency medicine, geriatrics and general medicine. In total 76 specialists from different disciplines participated in this project. Emerging Risk Stratification in Syncope