Prospective evaluation of non-pharmacological treatment in vasovagal syncope.
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.
Romme
Jacobus J C M
JJ
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, J1b-214, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands.
Reitsma
Johannes B
JB
Go-Schön
Ingeborg K
IK
Harms
Mark P M
MP
Ruiter
Jaap H
JH
Luitse
Jan S K
JS
Lenders
Jacques W M
JW
Wieling
Wouter
W
van Dijk
Nynke
N
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
D012982:Sodium, Dietary