Department of Electrophysiology, University Heart Center Hamburg, Martinistrasse, 52 20246 Hamburg, Germany.
Europace. 2012 Mar;14(3):410-5. doi: 10.1093/europace/eur341. Epub 2011 Nov 1.
The aim of this study was to assess the role of a non-pharmacological approach on the frequency of traumatic injuries and syncope recurrence in patients with vasovagal syncope and normal hearts. We report the experience in our syncope centre with a standardized education and teaching protocol for patients with vasovagal syncope. The treatment of vasovagal syncope is often complex and discouraging. Besides medical options, behaviour modification is a main component of therapy but has no statistical evidence to support its use.
Between January 1999 and September 2006, we prospectively enrolled all patients with vasovagal syncope. The patients were counselled about the benign nature of their disease. Specific recommendations were made according to a standardized education protocol established at our syncope centre. A pre-/post-study was conducted to investigate the effectiveness of our approach on syncope recurrence and frequency of injury as the study endpoints. Complete follow-up data were available from 85% of the study population (316 of 371) after a mean time of 710 ± 286 days (mean age 50 years; standard deviation ± 18 years, 160 female). Eighty-seven patients (27.5%) had a syncope recurrence with 22 suffering an injury during syncope. During the follow-up period, the syncope burden per month was significantly reduced from 0.35 ± 0.03 at initial presentation to 0.08 ± 0.02 (P< 0.001). The frequency of traumatic syncope was significantly lower at the time of recurrence compared with the initial presentation (25 vs. 42%; McNemar's test P= 0.02).
A standardized education protocol significantly reduces traumatic injuries and syncope recurrence in patients with vasovagal syncope.
本研究旨在评估非药物治疗方法对心正常的血管迷走性晕厥患者创伤性损伤和晕厥复发频率的作用。我们报告了我们晕厥中心的经验，该中心对血管迷走性晕厥患者采用了标准化的教育和教学方案。血管迷走性晕厥的治疗往往很复杂，也令人沮丧。除了医疗选择外，行为改变是治疗的主要组成部分，但没有统计学证据支持其使用。
1999 年 1 月至 2006 年 9 月，我们前瞻性地招募了所有血管迷走性晕厥患者。向患者介绍了他们疾病的良性性质。根据我们晕厥中心制定的标准化教育方案，提出了具体建议。进行了预/后研究，以调查我们的方法对晕厥复发和损伤频率的有效性，作为研究终点。在平均 710±286 天（平均年龄 50 岁；标准差±18 岁，160 名女性）后，从 371 名研究人群中获得了 85%的完整随访数据（316 名）。87 名患者（27.5%）出现晕厥复发，22 名患者在晕厥时发生损伤。在随访期间，每月的晕厥负担从初始表现时的 0.35±0.03 显著降低至 0.08±0.02（P<0.001）。与初始表现相比，复发时创伤性晕厥的频率显著降低（25%比 42%；McNemar 检验 P=0.02）。
标准化教育方案可显著降低血管迷走性晕厥患者的创伤性损伤和晕厥复发。
