Is head injury characteristic of arrhythmic syncope?

Abstract

BackgroundOf the syncope types, arrhythmic syncope is the most life threatening and therefore requires proper treatment. However, the clinical predictors of arrhythmic syncope remain unknown. Some patients with syncope suffer from head injury, a serious side effect whose importance in the differential diagnosis of syncope has not been fully studied. Here, we attempted to identify the clinical characteristics of arrhythmic syncope, including the role played by head injuries. MethodsWe studied inpatients referred to the cardiology section for the diagnosis and treatment of syncope. Clinical characteristics including age, sex, incidence of head injury during syncope, and cardiologic studies were evaluated in patients with arrhythmic and non-arrhythmic syncope. ResultsOf 5590 inpatients, 273 (4.8%) (170 men; mean age, 61±17 years) suffered a syncopal episode before admission, 119 (43%) of whom were diagnosed with arrhythmic syncope and 30 (11%) of whom were undiagnosed. In multivariate analysis, age >65 years (65% vs. 42%, p<0.005), abnormal electrocardiogram (66% vs. 43%, p<0.01), and the presence of a head injury (31% vs. 16%, p<0.01) were more prevalent in patients with arrhythmic syncope than in patients with non-arrhythmic syncope. ConclusionsPatients with arrhythmic syncope were older, suffered collateral head injuries more frequently, and were more likely to have abnormal electrocardiograms than patients with non-arrhythmic syncope did.