719-2 Evolution of Patients with Neurocardiogenic (Vasovagal) Syncope not Subjected to a Specific Treatment

Abstract

The results obtained with some drugs or other therapeutic strategies in the prevention of neurocardiogenic syncope are encouraging. However, the benefit they represent when compared with the natural history of this disorder has not been clearly established. The purpose of this prospective study was to analyze the natural history of patients with neurocardiogenic syncope. Fifty-six consecutive patients with either: a) One or more episodes of syncope and a positive head-up Tilt test (29 patients), or b) Typical history of neurocardiogenic (vasovagal) syncope (27 patients) despite a negative Tilt test, were followed up by telephone or personal consultation during a mean period of 16.1 ± 10.2 months. Patients were discharged without any specific medication. There were no deaths during the follow-up period. Recurrences were found in 5 patients (8.9%). The risk of recurrence was 7% after one year and 15% after 21 months. The multivariate analysis showed the duration of symptoms before the inclusion as an independent variable related to recurrences (p < 0.025). The prognosis of patients with neurocardiogenic syncope is excellent as far as survival is concerned. Recurrences of episodes without any specific treatment are uncommon after diagnosis has taken place. This finding strengthens the need to evaluate the effect of drugs with placebo control groups and to select the highest risk group for treatment.