Efficacy of orthostatic self-training in medically refractory neurocardiogenic syncope.
BACKGROUND
Orthostatic self-training is effective in the prevention of neurocardiogenic syncope, though the success of this method in drug refractory patients has not been reported. STUDY OBJECTIVE AND METHODS: This study examined the effectiveness of orthostatic self-training in 15 patients with head-up tilt testing (HUT)-inducible neurocardiogenic syncope, who were intolerant of, or refractory to standard drug therapy. They were enrolled in a home orthostatic self-training program for up to 30 min/session, twice daily. Head-up tilt testing was repeated within 4 weeks after onset of the training program, using the same protocol as at baseline. Orthostatic self-training was continued once daily, for up to 30 min, for a mean follow-up period of 11 months, in the drug-free state.


RESULTS
Syncope was not reinducible by follow-up HUT, and spontaneous syncope occurred in no patient during the follow-up period.


CONCLUSIONS
Home orthostatic self-training, up to 30 min once daily following an initial twice daily program, was highly effective in the suppression of recurrent neurocardiogenic syncope in patients intolerant of, or refractory to standard drug therapy.
Abe
Haruhiko
H
The Second Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, Japan. haru-abe@med.uoeh-u.ac.jp
Kohshi
Kiyotaka
K
Nakashima
Yasuhide
Y
D000328:Adult; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011187:Posture; D012648:Self Care; D019462:Syncope, Vasovagal / Q000503:physiopathology / Q000517:prevention & control*