Kuriachan Vikas, Sheldon Robert S, Platonov Michael
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Heart Rhythm. 2008 Nov;5(11):1609-14. doi: 10.1016/j.hrthm.2008.08.023. Epub 2008 Aug 28.
Only a minority of patients with vasovagal syncope require treatment, and most can be managed conservatively. Patients should be encouraged to liberalize their fluid and salt intake, unless they have contraindications such as hypertension. All patients should be taught physical counterpressure maneuvers. Midodrine is the first-line therapy for patients having frequent presyncope or syncope or for those with brief or no prodromes. The routine use of beta-blockers, serotonin-specific reuptake inhibitors, fludrocortisone, and pacemakers is discouraged. Whether loop recorders can be used to target treatment is under investigation, as is fludrocortisone.
只有少数血管迷走性晕厥患者需要治疗，大多数患者可采用保守治疗。应鼓励患者增加液体和盐分摄入，除非他们有高血压等禁忌证。应向所有患者传授物理对抗压力动作。米多君是有频繁晕厥前症状或晕厥的患者或前驱症状短暂或无前驱症状患者的一线治疗药物。不建议常规使用β受体阻滞剂、5-羟色胺特异性再摄取抑制剂、氟氢可的松和起搏器。目前正在研究是否可使用环路记录器来指导治疗，氟氢可的松的情况也在研究中。
