title: [Vasovagal syncope in pediatric patients: a medium-term follow-up analysis].
abstract: OBJECTIVE
  Little information is available on the evolution of pediatric patients with vasovagal syncope. We therefore aimed to assess the medium-term clinical outcome of children evaluated by tilt testing for syncope of unknown origin.
  
  
  METHODS
  Fifty-one children under 17 years of age who had undergone tilt testing were identified from a data base and studied prospectively. Kaplan-Meier and Cox regression analyses were performed to estimate syncope-free survival, its predictors, and the relative risks of several patient subgroups.
  
  
  RESULTS
  Forty-seven (92%) of the children were followed for a mean 21 9 months. The rate of recurrence of syncope was considerably lower than that estimated during history taking before the tilt test (19% vs 47%; p < 0.01). Although the low rate made it difficult to identify predictors, several potential predictors emerged from the multivariate analysis. Only the history of more than one syncope before the tilt test (vs. isolated syncope) was found to have independent predictive value (p = 0.04). The cumulative probability of recurrence projected for a period of 38 months was 66.2% (SEM = 16.5%) for children with more than one syncope before testing vs. 0% for those who had experienced only one. No other events occurred.
  
  
  CONCLUSIONS
  The medium-term prognosis seems to be good for children with vasovagal syncope of unknown origin, given the low rate of recurrence, regardless of the results of tilt testing. The only predictor of recurrent syncope was pretest history, such that children with only one syncope before testing experience no recurrence and those with one or more episodes are estimated to have an increasingly higher likelihood of recurrence. These data may be useful for the recommending tilt testing and for planning therapy for children with vasovagal syncope.
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain. jfdiaz@hjrj.sas.junta-andalucia.es
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Díaz
authors.forename: Luis
authors.initials: L
authors.lastname: Tercedor
authors.forename: Eduardo
authors.initials: E
authors.lastname: Moreno
authors.forename: Rocío
authors.initials: R
authors.lastname: García
authors.forename: Miguel
authors.initials: M
authors.lastname: Alvarez
authors.forename: Jesús
authors.initials: J
authors.lastname: Sánchez
authors.forename: José
authors.initials: J
authors.lastname: Azpitarte
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000503:physiopathology; D018667:Tilt-Table Test