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Find the answers for your unexplained syncope patients
Cardiac syncope can be a predictor of sudden cardiac death3
Syncope patients endure ongoing diagnostic testing and still come away with no answers5
Class | Level of Evidence | Recommendations |
---|---|---|
I |
B-NR |
A detailed history and physical examination should be performed in patients with syncope |
I |
B-NR |
Evaluation of the cause and assessment for the short- and long-term morbidity and mortality risk of syncope are recommended |
The choice of monitoring system and duration should be appropriate to the likelihood that a spontaneous event will be detected, and the patient may be incapacitated and unable to voluntarily trigger the recording system.
Class | Level of Evidence | Recommendation |
---|---|---|
I |
C-EO |
The choice of a specific cardiac monitor should be determined on the basis of the frequency and nature of syncope events. |
IIa |
B-R |
To evaluate selected ambulatory patients with syncope of suspected arrhythmic etiology, an ICM can be useful. |
IIa |
B-NR |
To evaluate selected ambulatory patients with syncope of suspected arrhythmic etiology, the following external cardiac monitoring approaches can be useful:
|
Sun BC, Emond JA, Camargo CA Jr. Inconsistent electrocardiographic testing for syncope in United States emergency departments. Am J Cardiol. May 15, 2004;93(10):1306-1308.
Mendu ML, McAvay G, Lampert R, Stoehr J, Tinetti ME. Yield of diagnostic tests in evaluating syncopal episodes in older patients. Arch Intern Med. July 27, 2009;169(14):1299-1305.
Engel GL. Psychologic stress, vasodepressor (vasovagal) syncope, and sudden death. Ann Intern Med. September 1978;89(3):403-412.
Soteriades ES, Evans JC, Larson MG, et al. Incidence and prognosis of syncope. N Engl J Med. September 19, 2002;347(12):878-885.
Edvardsson N, Frykman V, van Mechelin R, et al. Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry. Europace. February 2011;13(2):262-269.
Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol. Published online March 9, 2017.