Mid-term follow-up of patients with vasovagal syncope

Objective: In this study, we aimed to evaluate 3-year mid-term follow-up results that consist of treatment response, frequency of recurrences, predisposing factors effective on recurrence and prognosis in patients with syncope and presyncope. We also aimed to obtain useful information that will contribute to follow-up and treatment of these patients. Methods: Medical files of 285 consecutive patients diagnosed as syncope between January 2008 and December 2009 were reviewed. retrospectively. and 114 patients with definitive diagnosis of vasovagal syncope were included in the study. Results: Vasovagal syncope (51.2%), pseudo-syncope (22.1%), syncope with neurological origin (14.4%), cardiac syncope (2.1%) and unexplained syncope (10.2%) were found in 285 patients who were examined for the presence of syncope. Also 114 patients diagnosed as vasovagal syncope. Our study population consisted of female (58.8%), and male (41.2%) patients. Female to male ratio was 1,4. Mean age at presentation (11.7 +/- 2.5 years), mean age at first syncope (11.3 +/- 5.2 years), and the mean duration of follow-up (42.8 +/- 3.4 months) were also estimated During the follow-up period syncope recurred in 31 patients (27.2%). Any effects of sex, absence or presence of prodromal symptoms, response type to tilt table test at the time of diagnosis on the recurrence and type of syncope were not found. Significant decrease was seen in the number of syncope attacks after the tilt table test. The recurrence of syncope was observed in 15 of 26 patients who were treated with beta blockers, and in 16 of 88 untreated patients. Recurrence of syncope was more frequent in patients with drug therapy. Conclusion: In the pediatric age, education and recommendations, increasing fluid and salt intake are successful forms of treatment for vasovagal syncope. In patients with recurrent syncope attacks beta blocker treatment is used besides the recommendations. But the effect of the beta blocker therapy for preventing the recurrence is limited. For this reason, medication should be used only in cases with frequently recurrent vasovagal syncope attacks.