Usefulness of a tilt training program for the prevention of refractory neurocardiogenic syncope in adolescents: A controlled study
| Autor: | Antonio Barsotti, Luigi Leonzio, Cesare Di Iorio, P. Sabatini, Enrico Di Girolamo |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Fludrocortisone Posture Neurological disorder Orthostatic vital signs Quality of life Refractory Recurrence Physiology (medical) medicine Syncope Vasovagal Humans Motivation biology business.industry Syncope (genus) medicine.disease biology.organism_classification Exercise Therapy Clinical trial Physical therapy Female Cardiology and Cardiovascular Medicine business Tilt training medicine.drug |
| Zdroj: | Circulation. 100(17) |
| ISSN: | 1524-4539 |
| Popis: | Background —Recurrent syncope represents a debilitating disorder and quality of life deteriorates as a function of recurrence of symptoms. Although the administration of β-blockers, vasoconstrictors, fludrocortisone, and serotonin reuptake inhibitors may be helpful in preventing episodes, many patients are intolerant of or respond poorly to these agents. Orthostatic training has been reported to be effective in preventing refractory syncope. Thus, to determine whether a tilt training program could prevent symptoms in adolescents, the following controlled study was undertaken. Methods and Results —Forty-seven consecutive adolescents (18 male and 29 female, mean age 16.0±2.2 years) with recurrent syncope and positive head-up tilt test refractory to previous traditional therapies were distributed between 2 groups, depending on their consent (24 patients) or refusal (controls, 23 patients) to enter the program. Orthostatic training was started, in the presence of a family member, with a series of 5 in-hospital sessions. The 24 patients and their relatives were then instructed to perform the tilt training at home by standing against a wall twice a day for a planned duration of up to 40 minutes, depending on the in-hospital orthostatic tolerance. Head-up tilt response was reevaluated after 1 month, and the clinical effect was noted over a mean follow-up of 18.2±5.3 months (range 15 to 23); 26.1% of patients in the control group and 95.8% of patients in the training group became tilt-negative ( P P Conclusions —Orthostatic training was found to significantly improve symptoms of adolescents with neurocardiogenic syncope unresponsive to or intolerant of traditional medications. Twice-a-day training sessions of 40 minutes were well accepted by patients. |
| Databáze: | OpenAIRE |
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