Bastos Silvana, Scanavacca Mauricio, Darrieux Francisco, Ludovice Ana Cristina, Sosa Eduardo, Hachul Denise Tessariol
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP.
Arq Bras Cardiol. 2006 Apr;86(4):256-60. doi: 10.1590/s0066-782x2006000400004. Epub 2006 Apr 25.
To evaluate the outcome of patients with NCS after interruption of pharmacological therapy and to investigate the possible clinical variables predicting recurrence.
Thirty-seven patients (age 31+/-16 years) with refractory recurrent NCS being 19 females where prospectively studied. All patients became asymptomatic and had a negative tilt table test (TT) after pharmacological therapy. The treatment was interrupted and one month later, a new TT with no medication was carried out. The probability free of symptoms recurrence was analyzed according to sex, age, number of syncope episodes previously to the treatment, clinical history time, treatment time, drug free from treatment time and TT result.
Twenty-two patients (59%) presented recurrence during a mean follow-up of 21+/-19.7 months. The variables related to greater recurrence were number of previous syncope (p=0.0248), positive TT after interruption of the therapy (p=0.0002) and female gender (p=0.0131).
Most of the very symptomatic patients with NCS present recurrence after the suppression of a specific therapy. A TT carried out after treatment discontinuation can identify patients with higher risk of recurrence, specially in the first year of follow-up.
