Copyright © 1991 by the European Society of Cardiology.
© 1991 The European Society of Cardiology
Electrophysiologic evaluation and outcome of patients with syncope of unknown origin
Montreal Heart Institute Montreal, Canada
Received 3 October 1989; revised 1 April 1990; .
Address for reprints: Denis Roy, MD, Montreal Heart Institute, 5000 east Belanger Street, Montreal, Quebec HIT IC8, Canada.
Abstract
Electrophysiologic studies were performed in 134 patients (87 males, mean age 59 years) with unexplained syncope. Seventy-one patients had organic heart disease (ischaemic in 50). Electrophysiologic studies revealed conduction abnormalities and tachy arrhythmias that could account for syncope in 40 patients (30%). Thirty-seven (93%) of these patients received pacing or antiarrhythmic therapy compared with 23 (24%) of the remaining 94 patients who had a negative study and received empiric therapy (P < 0.0001). Risk of having an abnormal electrophysiologic study was greater in patients with underlying heart disease (P<0.05). During a mean follow-up of 22±17 months, 26 patients (19%) either had recurrent syncope (22 patients) or died (four patients) suddenly. Men had a higher incidence of recurrent syncope than women (26% vs 6%, P<0.005). Other clinical characteristics, electrophysiologic findings, final diagnosis and therapy at discharge were not predictive of outcome.
We conclude that (1) 19% of patients investigated for syncope will have a recurrent event, (2) female gender may be an independent predictor of favourable outcome.
Key Words: Syncope • electrophysiology
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