Efficacy of tilt training in the treatment of neurally mediated syncope. A randomized study
| Autor: | Giovanni Foglia-Manzillo, Michele Brignole, Germano Gaggioli, Angelo Bartoletti, Maurizio Dinelli, Gino Lolli, Antonio Raviele, Franco Giada, Mauro Santarone, Attilio Del Rosso |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Posture Blood Pressure law.invention Tilt table test Randomized controlled trial Heart Rate Tilt-Table Test law Physiology (medical) Heart rate Secondary Prevention Syncope Vasovagal Humans Medicine Prospective Studies Treatment Failure Prospective cohort study Vasovagal syncope medicine.diagnostic_test business.industry Middle Aged medicine.disease Clinical trial Tilt (optics) Blood pressure Anesthesia Feasibility Studies Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Europace. 6:199-204 |
| ISSN: | 1099-5129 |
| DOI: | 10.1016/j.eupc.2004.01.002 |
| Popis: | Recurrent neurally mediated syncope represents a common clinical event and a therapeutic challenge. Recently tilt training has been proposed for the treatment of recurrent neurally mediated syncope. To evaluate the efficacy of tilt training in preventing tilt-induced syncope and its feasibility, this controlled, randomized study was undertaken. Sixty-eight consenting patients (25 males and 43 females, mean age 40 +/- 19) with recurrent neurally mediated syncope and 2 consecutive positive nitroglycerin-potentiated head-up tilt tests were randomized to tilt training (35 patients) or no treatment (controls, 33 patients). The tilt training programme consisted of daily 30-min sessions of upright standing against a vertical wall 6 days a week for at least 3 weeks, until a reevaluation tilt test (3 patients of both groups dropped out). On this third head-up tilt test, 19 (59%) of 32 tilt trained patients and 18 (60%) of 30 controls still had a positive test. Treated patients performed a mean number of 15 +/- 7 sessions (median 16) and only 11 patients (34%) did all the programmed sessions. Only 1 patient (3%) discontinued treatment because of intolerance, while all other patients did not perform tilt training adequately, because of poor compliance. Thus, in our study tilt training was not effective in reducing tilt testing positivity rate in patients with neurally mediated syncope. Because of poor compliance, tilt training appears to be a feasible treatment only for highly motivated patients, but not for the majority of patients with recurrent neurally mediated syncope. |
| Databáze: | OpenAIRE |
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