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Long-term follow-up of children and adolescents with syncope; predictor of syncope recurrence.
Eur Heart J. 2001 Sep; 22(17):1618-25.EH

Abstract

BACKGROUND

Previous studies have shown that investigation by tilt testing is very appropriate in paediatrics, but the characteristics of children and adolescents who are at high risk of recurrent syncope, once the diagnosis is established, remain unclear. This study was set up to analyse the risk factors attributed to syncope recurrence in paediatric patients.

METHODS

One hundred and one children and adolescents aged 7 to 18 years, undergoing a tilt test for recurrent syncope, were studied. They were subsequently followed-up in clinic visits with a final interview at the clinic or by telephone at the end of the follow-up period.

RESULTS

A head-up tilt test elicited syncope or pre-syncope in 67 children. The positive responses included vasovagal syncope in 58 patients and psychogenic syncope in nine patients. Gender, age, number of pre-tilt test syncopal episodes or duration of symptoms made no difference to children with positive or negative tilt test results. Following the tilt test, 43 of 67 children with a positive tilt test were treated empirically. No treatment was prescribed for the remaining 24 with a positive test, or for those with a negative tilt test. There were no differences between treated and untreated children with respect to the number of pre-tilt test syncopes, duration of symptoms and duration of follow-up. Follow-up data were available in 97 children. During a mean follow-up of 46+/-28 months, syncope recurred in 31 children (32%). The recurrence rate was similar between positive and negative tilt test groups (22/66 vs 9/31, respectively; P=ns), as well as between treated and untreated children (14/43 vs 8/23, respectively; P=ns). When comparing syncope-free children at follow-up in a univariate analysis, children with recurrent syncope reported a greater number of historical syncopal spells (7+/-8 vs 3+/-3, P=0.01). In addition linear correlation (r=0.6, 95% CI 0.47 to 0.72, P<0.0001) was significant between the number of historical syncope episodes and the risk of recurrent syncope.

CONCLUSIONS

These findings suggest that the risk of syncope recurrence for children and adolescents with such a history is not correlated to the tilt test result or prophylactic treatment. The number of historical syncopal spells is, however, predictive.

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Authors+Show Affiliations

Kouakam C
Department of Cardiac Pacing and Electrophysiology, University of Lille, CHR & U 59037 Lille Cedex, France
Vaksmann G
No affiliation info available
Pachy E
No affiliation info available
Lacroix D
No affiliation info available
Rey C
No affiliation info available
Kacet S
No affiliation info available

MeSH

AdolescentChildFemaleFollow-Up StudiesHumansMaleRecurrenceRisk FactorsSyncopeTilt-Table Test

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11492992

Citation

Kouakam, C, et al. "Long-term Follow-up of Children and Adolescents With Syncope; Predictor of Syncope Recurrence." European Heart Journal, vol. 22, no. 17, 2001, pp. 1618-25.
Kouakam C, Vaksmann G, Pachy E, et al. Long-term follow-up of children and adolescents with syncope; predictor of syncope recurrence. Eur Heart J. 2001;22(17):1618-25.
Kouakam, C., Vaksmann, G., Pachy, E., Lacroix, D., Rey, C., & Kacet, S. (2001). Long-term follow-up of children and adolescents with syncope; predictor of syncope recurrence. European Heart Journal, 22(17), 1618-25.
Kouakam C, et al. Long-term Follow-up of Children and Adolescents With Syncope; Predictor of Syncope Recurrence. Eur Heart J. 2001;22(17):1618-25. PubMed PMID: 11492992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up of children and adolescents with syncope; predictor of syncope recurrence. AU - Kouakam,C, AU - Vaksmann,G, AU - Pachy,E, AU - Lacroix,D, AU - Rey,C, AU - Kacet,S, PY - 2001/8/9/pubmed PY - 2001/9/21/medline PY - 2001/8/9/entrez SP - 1618 EP - 25 JF - European heart journal JO - Eur Heart J VL - 22 IS - 17 N2 - BACKGROUND: Previous studies have shown that investigation by tilt testing is very appropriate in paediatrics, but the characteristics of children and adolescents who are at high risk of recurrent syncope, once the diagnosis is established, remain unclear. This study was set up to analyse the risk factors attributed to syncope recurrence in paediatric patients. METHODS: One hundred and one children and adolescents aged 7 to 18 years, undergoing a tilt test for recurrent syncope, were studied. They were subsequently followed-up in clinic visits with a final interview at the clinic or by telephone at the end of the follow-up period. RESULTS: A head-up tilt test elicited syncope or pre-syncope in 67 children. The positive responses included vasovagal syncope in 58 patients and psychogenic syncope in nine patients. Gender, age, number of pre-tilt test syncopal episodes or duration of symptoms made no difference to children with positive or negative tilt test results. Following the tilt test, 43 of 67 children with a positive tilt test were treated empirically. No treatment was prescribed for the remaining 24 with a positive test, or for those with a negative tilt test. There were no differences between treated and untreated children with respect to the number of pre-tilt test syncopes, duration of symptoms and duration of follow-up. Follow-up data were available in 97 children. During a mean follow-up of 46+/-28 months, syncope recurred in 31 children (32%). The recurrence rate was similar between positive and negative tilt test groups (22/66 vs 9/31, respectively; P=ns), as well as between treated and untreated children (14/43 vs 8/23, respectively; P=ns). When comparing syncope-free children at follow-up in a univariate analysis, children with recurrent syncope reported a greater number of historical syncopal spells (7+/-8 vs 3+/-3, P=0.01). In addition linear correlation (r=0.6, 95% CI 0.47 to 0.72, P<0.0001) was significant between the number of historical syncope episodes and the risk of recurrent syncope. CONCLUSIONS: These findings suggest that the risk of syncope recurrence for children and adolescents with such a history is not correlated to the tilt test result or prophylactic treatment. The number of historical syncopal spells is, however, predictive. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/11492992/Long_term_follow_up_of_children_and_adolescents_with_syncope L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1053/euhj.2000.2577 DB - PRIME DP - Unbound Medicine ER -