The article by Kouakam et al. in issue 22/17 is a prospective observational study of syncope recurrence in 101 children (mean age 12·6 3; range 7–18 years) undergoing head-up tilt testing for investigation of recurrent unexplained syncope or presyncope. Data are presented for patients recruited between 1990 and 1998, and followed-up for an average of 4 years. Head-up tilt was initially positive...

BACKGROUND Syncope is a transient loss of consciousness, associated with loss of postural tone, with spontaneous return to baseline neurologic function. Syncope is a common complaint in the emergency department. OBJECTIVES Cough syncope occurs immediately after coughing. Cough syncope rapidly recovers in 1-2 second. Although cough syncope has been classified in vasovagal syncope, it may diffe...

Abstract Scope. The aim of the study was to evaluate how Covid–19 state emergency affected activity Syncope Unit (SU). During lockdown, outpatient activities SU were suspended(1). Materials. From March 2020 2021, approximately 95 patients booked for Tilt–up test medically evaluated by teleconsultation and televiewer. Vasovagal syncope (VVS) (61%), orthostatic hypotension (OH) (5%) diagnosed. tr...

In their case report in this issue of Europace, Samniah et al. conclude as follows: ‘Inasmuch as current recommendations favour implantable defibrillators in symptomatic Brugada syndrome, the identification of other causes of syncope in such patients poses an uncomfortable and currently unsettled dilemma’. We cannot agree more with this statement. In 1996, we were approached by a 40-year-old fe...

OBJECTIVES We studied hemodynamic changes leading to orthostatic vasovagal presyncope to determine whether changes of cerebral artery blood flow velocity precede or follow reductions of arterial pressure. BACKGROUND Some evidence suggests that disordered cerebral autoregulation contributes to the occurrence of orthostatic vasovagal syncope. We studied cerebral hemodynamics with transcranial D...

We describe the multiresolution wavelet analysis of blood pressure waves in vasovagal-syncope affected patients compared with healthy people. We argue that there exist discriminating criteria which allow us to isolate particular features, common to syncope-affected patients sample, indicating a tentative, alternative diagnosis methodology for this syndrome. We perform a throughout analysis both...

There is growing scepticism over utility of tilt-testing for syncope diagnosis, which has been shown unable to distinguish vasovagal from other syncope, especially cardiac, despite its acceptable sensitivity and specificity in true positive and negative subjects. The new interpretation is that the test reveals a susceptibility to reflex hypotension, which may exist in coincidence with any cause...

The head-up tilt test (HUTT) is widely used for investigation of syncope and presyncope, since it allows diagnosing different types of dysautonomia. The main cause of syncope is the vasovagal syndrome, the most common diagnosis among patients with HUTT indication. The test has been used for nearly 20 years, but many doctors are unaware of the methodology. After the cardiac causes of syncope are...