A novel method for the diagnosis of neurocardiogenic syncope: heart rate recovery index.
OBJECTIVE
Neurocardiogenic syncope is a common and challenging problem in clinical practice. Heart rate recovery after the first minute of exercise is mainly controlled by the parasympathetic nervous system. The aim of the present study was to evaluate heart rate recovery as an index of parasympathetic tonus for the diagnosis of neurocardiogenic syncope.


RESULTS
Ninety five patients (mean age 36.5 +/- 11.8 years), who had vasovagal syncope episodes documented by tilt table testing and 70 healthy subjects (mean age 32.9 +/- 9.1 years) were included in this study. Maximal exercise stress testing was performed in both groups and heart rate recovery values were calculated. Heart rate recovery was calculated by subtracting recovery heart rate in the first minute after exercise from peak heart rate. Heart rate recovery was significantly higher in the vasovagal syncope group than the control group during the first minute (42.1 vs. 30.9, p < 0.001). When the cutoff point for heart rate recovery was taken as 35, the sensitivity for the diagnosis of vasovagal syncope was 81% and the specificity was 78%.


CONCLUSIONS
Results of our study show that heart rate recovery is greater in the first minute after exercise in vasovagal syncope patients and that it has a supportive role in the diagnosis of neurocardiogenic syncope.
Department of Cardiology, Hacettepe University, Ankara TR-06100, Turkey. doctorkaya@yahoo.com
Uğur
U
Kocabaş
Ergun Bariş
EB
Kaya
Kudret
K
Aytemir
Hikmet
H
Yorgun
Alper
A
Kepez
Hakan
H
Aksoy
Ahmet Hakan
AH
Ateş
Erol
E
Tulumen
Onur Sinan
OS
Deveci
Giray
G
Kabakci
Lale
L
Tokgozoğlu
Nasih
N
Nazli
Hilmi
H
Ozkutlu
Ali
A
Oto
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000503:physiopathology*; D018667:Tilt-Table Test; D055815:Young Adult