Copyright © 2004 by the European Society of Cardiology.
ESC Guidelines
Guidelines on management (diagnosis and treatment) of syncope – Update 2004
The task force on Syncope, European Society of Cardiology
Task Force members,Executive Summary
| The first 150 words of the full text of this article appear below. |
ESC Committee for Practice Guidelines (CPG): Silvia G. Priori (Chairperson) (Italy), Maria Angeles Alonso Garcia (Spain), Jean-Jacques Blanc (France), Andrzej Budaj (Poland), Martin Cowie (UK), Jaap Deckers (The Netherlands), Enrique Fernandez Burgos (Spain), John Lekakis (Greece), Bertil Lindhal (Sweden), Gianfranco Mazzotta (Italy), João Morais (Portugal), Ali Oto (Turkey), Otto Smiseth (Norway)
Document reviewers: Silvia G. Priori (CPG Review Coordinator) (Italy), Martin Cowie (UK), Carlo Menozzi (Italy), Hugo Ector (Belgium), Ali Oto (Turkey), Panos Vardas (Greece)
Preamble
Guidelines and Expert Consensus documents aim to present all the relevant evidence on a particular issue in order to help physicians to weigh the benefits and risks of a particular diagnostic or therapeutic procedure. They should be helpful in everyday clinical decision-making.
A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) and by different organisations and other related societies. This profusion can
Introduction
Part 1. The initial evaluation
The diagnostic strategy based on the initial evaluation
Non-syncopal conditions
Certain diagnosis
Suspected diagnosis
Unexplained syncope
Re-appraisal
Part 2. Diagnostic tests
Electrocardiographic monitoring (non-invasive and invasive)
Electrophysiological testing
Suspected ventricular tachycardia
ATP test
Part 3. Treatment
Neurally-mediated (reflex) syncope
Part 4. Special issues
Syncope in paediatric patients
Syncope management facilities
Professional skill mix for the syncope evaluation facility
Equipment
Setting
Driving and syncope
Appendix A: ESC Task Force on Guidelines on management (diagnosis and treatment) of syncope
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Answers Emerg. Med. J., November 1, 2009; 26(11): 830 - 830. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Sorajja, G. C. Nesbitt, D. O. Hodge, P. A. Low, S. C. Hammill, B. J. Gersh, and W.-K. Shen Syncope While Driving: Clinical Characteristics, Causes, and Prognosis Circulation, September 15, 2009; 120(11): 928 - 934. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Curtis and A. E. Epstein Syncope While Driving: How Safe Is Safe? Circulation, September 15, 2009; 120(11): 921 - 923. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Flevari, D. Leftheriotis, C. Komborozos, K. Fountoulaki, N. Dagres, G. Theodorakis, and D. Kremastinos Recurrent vasovagal syncope: comparison between clomipramine and nitroglycerin as drug challenges during head-up tilt testing Eur. Heart J., September 2, 2009; 30(18): 2249 - 2253. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Marti-Almor, M. Cladellas, V. Bazan, C. Altaba, M. Guijo, J. Delclos, and J. Bruguera-Cortada Long-term mortality predictors in patients with chronic bifascicular block Europace, September 1, 2009; 11(9): 1201 - 1207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. V. Quinn Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients--Invited Commentary Arch Intern Med, July 27, 2009; 169(14): 1305 - 1306. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Mussi, A. Ungar, G. Salvioli, C. Menozzi, A. Bartoletti, F. Giada, A. Lagi, I. Ponassi, G. Re, R. Furlan, et al. Orthostatic Hypotension As Cause of Syncope in Patients Older Than 65 Years Admitted to Emergency Departments for Transient Loss of Consciousness J Gerontol A Biol Sci Med Sci, July 1, 2009; 64A(7): 801 - 806. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C J Stockley, M E Bonney, A J Gray, and M J Reed Syncope management in the UK and Republic of Ireland Emerg. Med. J., May 1, 2009; 26(5): 331 - 333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Spirito, C. Autore, C. Rapezzi, P. Bernabo, R. Badagliacca, M. S. Maron, S. Bongioanni, F. Coccolo, N.A. M. Estes, C. S. Barilla, et al. Syncope and Risk of Sudden Death in Hypertrophic Cardiomyopathy Circulation, April 7, 2009; 119(13): 1703 - 1710. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L Plug and M Reuber Making the diagnosis in patients with blackouts: it's all in the history Practical Neurology, February 1, 2009; 9(1): 4 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. McCarthy, C. G. McMahon, U. Geary, P. K. Plunkett, R. A. Kenny, and C. J. Cunningham Management of syncope in the Emergency Department: a single hospital observational case series based on the application of European Society of Cardiology Guidelines Europace, February 1, 2009; 11(2): 216 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M E Bonney, M J Reed, and A J Gray The Prediction of Risk In Syncope using ECG characteristics (PRISE) pilot study: can heart rate variability be used to predict risk in patients presenting to the emergency department with syncope? Emerg. Med. J., January 1, 2009; 26(1): 32 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Lelonek, T. Pietrucha, M. Matyjaszczyk, and J. H. Goch A novel approach to syncopal patients: association analysis of polymorphisms in G-protein genes and tilt outcome Europace, January 1, 2009; 11(1): 89 - 93. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. Vardas, H. E. Mavrakis, and W. D. Toff CHAPTER 27 Bradycardia ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Katritsis and M. M. Webb-Peploe CHAPTER 38 Occupational and Regulatory Aspects of Heart Disease ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Timoteo, M. M. Oliveira, J. Feliciano, E. Antunes, M. N. da Silva, S. Silva, S. Santos, and R. Ferreira Head-up tilt testing with different nitroglycerin dosages: experience in elderly patients with unexplained syncope Europace, September 1, 2008; 10(9): 1091 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Verheyden, H. Ector, A. E. Aubert, and T. Reybrouck Tilt training increases the vasoconstrictor reserve in patients with neurally mediated syncope evoked by head-up tilt testing Eur. Heart J., June 2, 2008; 29(12): 1523 - 1530. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. van Dijk, R. D. Thijs, and W. Wieling Prognosis of Transient Neurological Attacks JAMA, April 16, 2008; 299(15): 1771 - 1772. [Full Text] [PDF]
|
|
|
|
|
|
F. Ammirati, R. Colaceci, A. Cesario, S. Strano, A. Della Scala, I. Colangelo, T. De Santo, E. Toscano, R. Ricci, and M. Santini Management of syncope: clinical and economic impact of a Syncope Unit Europace, April 1, 2008; 10(4): 471 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Auer Syncope and trauma. Are syncope-related traumatic injuries the key to find the specific cause of the symptom? Eur. Heart J., March 1, 2008; 29(5): 576 - 578. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kuhne, B. Schaer, N. Moulay, C. Sticherling, and S. Osswald Holter monitoring for syncope: diagnostic yield in different patient groups and impact on device implantation QJM, December 1, 2007; 100(12): 771 - 777. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Benezet-Mazuecos, B. Ibanez, J. M. Rubio, F. Navarro, E. Martin, J. Romero, and J. Farre Utility of in-hospital cardiac remote telemetry in patients with unexplained syncope Europace, December 1, 2007; 9(12): 1196 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Reybrouck and H. Ector Exercise training and baroreflex sensitivity in patients with neurally mediated syncope Eur. Heart J., November 2, 2007; 28(22): 2697 - 2698. [Full Text] [PDF]
|
|
|
|
|
|
M. J Reed, D. E Newby, A. J Coull, K. G Jacques, R. J Prescott, and A. J Gray Role of brain natriuretic peptide (BNP) in risk stratification of adult syncope Emerg. Med. J., November 1, 2007; 24(11): 769 - 773. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V.K. Marrison and S.W. Parry A case of nocturnal fainting: supine vasovagal syncope Europace, September 1, 2007; 9(9): 835 - 836. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Maggi, C. Menozzi, M. Brignole, C. Podoleanu, M. Iori, R. Sutton, A. Moya, F. Giada, S. Orazi, and N. Grovale Cardioinhibitory carotid sinus hypersensitivity predicts an asystolic mechanism of spontaneous neurally mediated syncope Europace, August 1, 2007; 9(8): 563 - 567. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J Reed, D. E Newby, A. J Coull, K. G Jacques, R. J Prescott, and A. J Gray The Risk stratification Of Syncope in the Emergency department (ROSE) pilot study: a comparison of existing syncope guidelines Emerg. Med. J., April 1, 2007; 24(4): 270 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The Steering Committee of the ISSUE 3 Study International study on syncope of uncertain aetiology 3 (ISSUE 3): pacemaker therapy for patients with asystolic neurally-mediated syncope: rationale and study design Europace, January 1, 2007; 9(1): 25 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Brignole Diagnosis and treatment of syncope Heart, January 1, 2007; 93(1): 130 - 136. [Full Text] [PDF]
|
|
|
|
 |
|
 C Masson Carotid sinus hypersensitivity: an age-related phenomenon J. Neurol. Neurosurg. Psychiatry, November 1, 2006; 77(11): 1207 - 1207. [Full Text] [PDF]
|
|
|
|
 |
|
 Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF]
|
|
|
|
|
|
Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF]
|
|
|
|
|
|
M J Reed and A Gray Collapse query cause: the management of adult syncope in the emergency department. Emerg. Med. J., August 1, 2006; 23(8): 589 - 594. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Brignole, A. Ungar, A. Bartoletti, I. Ponassi, A. Lagi, C. Mussi, M. A. Ribani, G. Tava, M. Disertori, F. Quartieri, et al. Standardized-care pathway vs. usual management of syncope patients presenting as emergencies at general hospitals. Europace, August 1, 2006; 8(8): 644 - 650. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M Morgan Basics of cardiac pacing: selection and mode choice. Heart, June 1, 2006; 92(6): 850 - 854. [Full Text] [PDF]
|
|
|
|
|
|
M. Brignole, R. Sutton, C. Menozzi, R. Garcia-Civera, A. Moya, W. Wieling, D. Andresen, D. G. Benditt, P. Vardas, and for the International Study on Syncope of Uncertai Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope Eur. Heart J., May 1, 2006; 27(9): 1085 - 1092. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. J. Kerr, M. S. Pearce, C. Brayne, R. J. Davis, and R. A. Kenny Carotid sinus hypersensitivity in asymptomatic older persons: implications for diagnosis of syncope and falls. Arch Intern Med, March 13, 2006; 166(5): 515 - 520. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sheldon, S. Rose, S. Connolly, D. Ritchie, M.-L. Koshman, M. Frenneaux, and for the Syncope Symptom Study Investigators Diagnostic criteria for vasovagal syncope based on a quantitative history Eur. Heart J., February 1, 2006; 27(3): 344 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Morillo Evidence-based common sense: the role of clinical history for the diagnosis of vasovagal syncope Eur. Heart J., February 1, 2006; 27(3): 253 - 254. [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. van Dijk, D. G. Benditt, and M. Brignole Case 26-2005: Loss of Consciousness while Jogging N. Engl. J. Med., January 12, 2006; 354(2): 209 - 209. [Full Text] [PDF]
|
|
|
|
|
|
M. Brignole, C. Menozzi, A. Bartoletti, F. Giada, A. Lagi, A. Ungar, I. Ponassi, C. Mussi, R. Maggi, G. Re, et al. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals Eur. Heart J., January 1, 2006; 27(1): 76 - 82. [Abstract] [Full Text] [PDF]
|
|