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176 results for “syncope”
Wearable Monitor in Patients With Syncope
ClinicalTrials.gov study NCT05782647. IPD Sharing: YES. Countries: 1. Publications: 0.
Syncope and Implanted Loop Recorder: the Utility of Remote Monitoring and Patients Centered Setting Alarms
ClinicalTrials.gov study NCT04435262. IPD Sharing: UNDECIDED. Countries: 1. Publications: 0.
National Registry of Cardioneuroablation in Recurrent Reflex Syncope
ClinicalTrials.gov study NCT06159764. IPD Sharing: Not stated. Countries: 1. Publications: 0.
Improving Management of Emergency Department Patients With Undifferentiated Syncope: Prospective Validation of the Canadian Syncope Risk Score
ClinicalTrials.gov study NCT05538143. IPD Sharing: NO. Countries: 1. Publications: 0.
Assessing the Risk of Pulmonary Embolism in Patients After Hospitalization for First Episode of Syncope
ClinicalTrials.gov study NCT03034525. IPD Sharing: NO. Countries: 0. Publications: 0.
The Effectiveness of Metoprolol in the Prevention of Syncope Recurrence in Children and Adolescents
ClinicalTrials.gov study NCT00475462. IPD Sharing: Not stated. Countries: 0. Publications: 0.
The Iliac Arterio-venous Fistula for Treatment of Neurally Mediated Syncope Study
ClinicalTrials.gov study NCT02388087. IPD Sharing: Not stated. Countries: 0. Publications: 0.
Implantable Loop Recorder in Traumatic Syncope
ClinicalTrials.gov study NCT04832542. IPD Sharing: NO. Countries: 0. Publications: 0.
Mobile Cardiac Outpatient Telemetry for Unexplained Syncope
ClinicalTrials.gov study NCT05957315. IPD Sharing: Not stated. Countries: 0. Publications: 0.
Autonomous Syncope Onset Prediction and Prevention
ClinicalTrials.gov study NCT02684539. IPD Sharing: NO. Countries: 0. Publications: 0.
Effect of Chronic Oral Hydration in Patients With Recurrent Unexplained Syncope
ClinicalTrials.gov study NCT00143754. IPD Sharing: Not stated. Countries: 0. Publications: 0.
Dynamic cerebrovascular autoregulation in patients prone to postural syncope: Comparison of techniques assessing the autoregulation index from spontaneous variability series
<p>Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Faes L, Porta A. Dynamic cerebrovascular autoregulation in patients prone to postural syncope: Comparison of techniques assessing the autoregulation index from spontaneous variability series. Auton Neurosci. 2022 Jan;237:102920. doi: 10.1016/j.autneu.2021.102920. Epub 2021 Nov 18. PMID: 34808528.</p> <p>Abstract</p> <p>Three approaches to the assessment of cerebrovascular autoregulation (CA) via the computation of the autoregulation index (ARI) from spontaneous variability of mean arterial pressure (MAP) and mean cerebral blood flow velocity (MCBFV) were applied: 1) a time domain method (TDM); 2) a nonparametric method (nonPM); 3) a parametric method (PM). Performances were tested over matched and surrogate unmatched pairs. Data were analyzed at supine resting (REST) and during the early phase of 60° head-up tilt (TILT) in 13 subjects with previous history of postural syncope (SYNC, age: 28 ± 9 yrs.; 5 males) and 13 control individuals (noSYNC, age: 27 ± 8 yrs.; 5 males). Analysis was completed by computing autonomic markers from heart period (HP) and systolic arterial pressure (SAP) variability series via spectral approach. HP and SAP spectral indexes suggested that noSYNC and SYNC groups exhibited different autonomic responses to TILT. ARI analysis indicated that: i) all methods have a sufficient statistical power to separate matched from unmatched pairs with the exception of nonPM applied to impulse response; ii) ARI estimates derived from different methods might be uncorrelated and, even when correlated, might exhibit a significant bias; iii) orthostatic stressor did not induce any evident ARI change in either noSYNC or SYNC individuals; iv) this conclusion held regardless of the method. Methods for the ARI estimation from spontaneous variability provide different ARIs but none indicate that noSYNC and SYNC subjects have different dynamic component of CA.</p>
Spectral decomposition of cerebrovascular and cardiovascular interactions in patients prone to postural syncope and healthy controls.
<p>Pernice R, Sparacino L, Bari V, Gelpi F, Cairo B, Mijatovic G, Antonacci Y, Tonon D, Rossato G, Javorka M, Porta A, Faes L. Spectral decomposition of cerebrovascular and cardiovascular interactions in patients prone to postural syncope and healthy controls. Auton Neurosci. 2022 Nov;242:103021. doi: 10.1016/j.autneu.2022.103021. Epub 2022 Aug 9. PMID: 35985253.</p> <p>Abstract</p> <p>We present a framework for the linear parametric analysis of pairwise interactions in bivariate time series in the time and frequency domains, which allows the evaluation of total, causal and instantaneous interactions and connects time- and frequency-domain measures. The framework is applied to physiological time series to investigate the cerebrovascular regulation from the variability of mean cerebral blood flow velocity (CBFV) and mean arterial pressure (MAP), and the cardiovascular regulation from the variability of heart period (HP) and systolic arterial pressure (SAP). We analyze time series acquired at rest and during the early and late phase of head-up tilt in subjects developing orthostatic syncope in response to prolonged postural stress, and in healthy controls. The spectral measures of total, causal and instantaneous coupling between HP and SAP, and between MAP and CBFV, are averaged in the low-frequency band of the spectrum to focus on specific rhythms, and over all frequencies to get time-domain measures. The analysis of cardiovascular interactions indicates that postural stress induces baroreflex involvement, and its prolongation induces baroreflex dysregulation in syncope subjects. The analysis of cerebrovascular interactions indicates that the postural stress enhances the total coupling between MAP and CBFV, and challenges cerebral autoregulation in syncope subjects, while the strong sympathetic activation elicited by prolonged postural stress in healthy controls may determine an increased coupling from CBFV to MAP during late tilt. These results document that the combination of time-domain and spectral measures allows us to obtain an integrated view of cardiovascular and cerebrovascular regulation in healthy and diseased subjects.</p>
Feasibility of Blood Pressure Measurement With a Wearable (Watch-Type) Monitor During Impending Syncopal Episodes
<p>BACKGROUND: We assessed the reliability and feasibility of blood pressure (BP) measurements by means of a new wearable<br> watch-type<br> BP monitor (HeartGuide) in detecting episodes of hypotensive (pre)syncope induced by tilt table test.<br> METHODS AND RESULTS: An intrapatient comparison between systolic BP (SBP) measured by means of the HeartGuide device<br> and noninvasive finger beat-to-<br> beat<br> BP monitoring was undertaken both at baseline in supine position and repeatedly during<br> tilt table test in patients evaluated for reflex syncope. Intrapatient fall of systolic BP from baseline was measured. Eighty-one<br> patients (mean age, 61±19 years; 46 women) were included. Overall, HeartGuide was able to yield BP values at the time of<br> BP nadir in 58 (72%) patients (average HeartGuide SBP 102±18 mm Hg, versus finger SBP 101±19 mm Hg). Compared with<br> baseline, the maximum SBP decrease was on average −28.5±27.8 and −30.3±33.9 mm Hg respectively (Lin’s concordance<br> correlation coefficient=0.78, r=0.79, P=0.001). In the subgroup of 38 patients with tilt table test induced (pre)syncope, the average<br> HeartGuide SBP during symptoms was 97±16 mm Hg, and the finger SBP was 94±18 mm Hg. Compared with baseline,<br> the maximum SBP decrease was on average −35.2±29.3 and −43.3±31.8 mm Hg, respectively (Lin’s concordance correlation<br> coefficient=0.83, r=0.87, P=0.001).<br> CONCLUSIONS: Our data indicate that the HeartGuide BP monitor can detect low BP during presyncope and that its measure<br> of SBP change is consistent with that simultaneously obtained through continuous BP monitoring, despite some intrapatient<br> variability. Thus, this device might be useful in determining the hypotensive nature of spontaneous (pre)syncopal symptoms, a<br> possibility that should be verified by field studies.</p>
Adenosine concentration in patients with neurally-mediated syncope
<p><strong>Background.</strong> Either high or low values of adenosine blood level (ABL) can differentiate some forms of neurally-mediated syncope (NMS). A rapid method of measurement has recently been developed. The aim of the present study was: 1) to compare ABLs in an unselected population of consecutive patients referred for evaluation of suspected NMS syncope and in healthy controls; and 2) to assess the relative prevalence of low and high adenosine forms among an unselected syncope population</p> <p><strong>Method.</strong> Whole blood was collected after finger puncture and its concentration was measured by liquid chromatography /mass spectrometry (LC-MS/MS).</p> <p><strong>Results. </strong>Among 89 control subjects, the median ABL value was 0.54 µM (IQR 0.46-0.65). The lowest 5% and the upper 95% percentile were 0.40 and 0.80 µM respectively. Compared with healthy subjects, the 146 syncope patients showed on average a higher median ABL value (0.63 [IQR 0.45-0.73, p=0.04) and a larger distribution of values. Low ABL values below the 5<sup>th</sup> percentile were observed in 28 (19%) patients and in 5 controls, p=0.003 and high ABL values were observed in 26 (18%) patients and 5 controls, p=0.009.</p> <p><strong>Conclusions. </strong>ABL is different in patients with suspected NMS than in healthy subjects. Patients with low and high adenosine values account for 19% and 18% of the general population. Thus, low and high ABL limits, as defined in this study, may help to define the purinergic profile of an unselected subjects with a clinical diagnosis of suspected NMS.</p>
Outcomes of primary vs delayed strategy of implanting a cardiac monitor for unexplained syncope
<p>Online Supplementary Files</p>
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Allen Brain Atlas
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