RT-196
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Neurocardiogenic syncope in
childhood and adolescence: evaluation by tilt-up testing and treatment with beta-blockers
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Mauro Biffi, Giuseppe Boriani,
Gabriele Bronzetti, Nicola De Simone, Romano Zannoli, Angelo Branzi, Bruno Magnani.
Institute of Cardiology, University of Bologna, Italy
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Abstract
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Background. Neurocardiogenic syncope
is a common problem in pediatric age and adolescence. We evaluated the long term outcome
of highly symptomatic patients with frequent recurrences (> 1/month) and with
traumatic syncopes respect to tilt-up guided therapy.
Methods. Fourteen consecutive patients were evaluated by head up tilt
test. Five were treated with beta-blockers by tilt-up guided therapy because of traumatic
recurrent syncopes.
Results. Among the 5 patients given prophylactic treatment, 4
converted to a normal response at repeated HUT; during long term follow-up (21 ± 5
months) only 1 of these 5 had syncopal recurrences, whereas 4 of the 9 untreated patients
had syncopal relapse. The total number of symptomatic events decreased in both study
groups at follow-up.
Conclusions. Neurocardiogenic syncope is a benign disorder in
childhood and adolescence. The tilt-up test is a reliable mean in the diagnosis of
"unexplained syncope" in young patients, and represents the most effective tool
to achieve tiered therapy. Pharmacological treatment is rarely needed in selected highly
symptomatic patients like those with traumatic syncope. Beta-blocking agents are very
effective when used at full dose with good tolerance also in pediatric patients.
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Key Words
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Peadiatric arrhythmias- management
neurocardiogenic syncope, tilt-up testing, beta-blockers, OA
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