Self-reported symptom burden; outcome in 418 patients from the Newcastle Vasovagal (Neurocardiogenic) cohort.
BACKGROUND
Natural history of Vasovagal syndrome (Neurocardiogenic; NCS) is unclear.


OBJECTIVE
To examine symptoms in a large cohort with head up tilt diagnosed NCS.


METHODS
Questionnaires were posted to 485 patients with NCS. Data included demographic details, age at referral, presenting and on-going symptoms (syncope, dizziness and falls), symptom frequency (daily, weekly, monthly) and burden.


RESULTS
A total of 418 questionnaires were returned (response rate 86%), 67% female. Median age at first presentation 60 (range 10-90), with men younger (54 vs. 63; P = 0.01). Seventy percent presented with syncope. Median follow-up 5 years (1-8). At follow-up 147(35%) were asymptomatic. The asymptomatic group was older (73 vs. 65; P = 0.0001) with more males (39 vs. 29%; P = 0.04). Those presenting with syncope were more likely to be symptom-free than those with dizziness (P < 0.02). Symptom frequency was greatest for those reporting dizziness at follow-up (P < 0.05). Sixty (22%) reported symptoms never preventing activities [predominantly those reporting dizziness (P = 0.04)]. Although there was a significant reduction of symptoms overall, there was a significant increase in those reporting dizziness only (P < 0.0001).


CONCLUSIONS
Of those with NCS, 35% will be symptom-free at 5 years regardless of presenting symptom or treatment received.
Ross
R
R
Falls and Syncope Service, University of Newcastle, Royal Victoria Infirmary, Newcastle NE1 4LP, UK.
Parry
S
S
Norton
M
M
Newton
J L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D012720:Severity of Illness Index; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D018667:Tilt-Table Test