title: Prospective evaluation of non-pharmacological treatment in vasovagal syncope.
abstract: OBJECTIVE
  Initial treatment of vasovagal syncope (VVS) consists of assuring an adequate fluid and salt intake, regular exercise and application of physical counterpressure manoeuvres. We examined the effects of this non-pharmacological treatment in patients with frequent recurrences.
  
  
  RESULTS
  One hundred patients with > or =3 episodes of VVS in the 2 years prior to the start of the study openly received non-pharmacological treatment. We evaluated this treatment both with respect to syncopal recurrences, factors associated with recurrence, and quality of life (QoL). The median number of syncopal recurrences was lower in the first year of non-pharmacological treatment compared with the last year before treatment (median 0 vs. 3; P < 0.001), but 49% of patients experienced at least one recurrence. In multivariable analysis, a higher syncope burden prior to inclusion was significantly associated with syncopal recurrence. Disease-specific QoL improved over time, with larger improvements for patients with more reduction in syncope burden.
  
  
  CONCLUSIONS
  In patients with frequent recurrences of VVS, non-pharmacological treatment has a beneficial effect on both syncopal recurrence and QoL, but nearly half of these patients still experience episodes of syncope.
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, J1b-214, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
authors.forename: Jacobus J C M
authors.initials: JJ
authors.lastname: Romme
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
authors.forename: Ingeborg K
authors.initials: IK
authors.lastname: Go-Schön
authors.forename: Mark P M
authors.initials: MP
authors.lastname: Harms
authors.forename: Jaap H
authors.initials: JH
authors.lastname: Ruiter
authors.forename: Jan S K
authors.initials: JS
authors.lastname: Luitse
authors.forename: Jacques W M
authors.initials: JW
authors.lastname: Lenders
authors.forename: Wouter
authors.initials: W
authors.lastname: Wieling
authors.forename: Nynke
authors.initials: N
authors.lastname: van Dijk
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology / Q000379:methods*; D001794:Blood Pressure; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007866:Leg; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011187:Posture; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012982:Sodium, Dietary; D019462:Syncope, Vasovagal / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012982:Sodium, Dietary