title: Efficacy of orthostatic self-training in medically refractory neurocardiogenic syncope.
abstract: 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.
authors.affiliation: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, Japan. haru-abe@med.uoeh-u.ac.jp
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Abe
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kohshi
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Nakashima
mesh_terms: 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*