| Autor: |
Wei-Ting Lai, Ming-Ren Chen, Shan-Miao Lin, Haw-Kwei Hwang |
| Jazyk: |
angličtina |
| Rok vydání: |
2010 |
| Předmět: |
|
| Zdroj: |
Journal of the Formosan Medical Association, Vol 109, Iss 9, Pp 641-646 (2010) |
| Druh dokumentu: |
article |
| ISSN: |
0929-6646 |
| DOI: |
10.1016/S0929-6646(10)60104-0 |
| Popis: |
We investigated the application of head-up tilt table testing (HUT) and management of neurocardiogenic syncope (NCS) in children, as pediatric studies are limited. Methods: Seventy-nine patients (ages 6-18 years) underwent HUT for evaluation of syncope. Patient triggers and premonitory symptoms allowed the clinical diagnosis of NCS or non-NCS. Results were divided into four hemodynamic types (1, 2A, 2B, and 3) according to patient response to HUT. Results: NCS occurred in 65 patients and non-NCS in 14 patients. Isoproterenol infusion significantly increased the sensitivity of the test (from 28% to 45%) and was associated with a slight decrease in the specificity (from 93% to 86%). Subjects in the type 1 group accounted for the majority of responses to the test (69%). There were no complications associated with the test. At follow-up (16.6 ± 9.3 months), the overall recurrence rate was 30.8% but NCS was less severe in most patients. The recurrence rate was similar for patients with a positive or negative HUT and for both pharmacologically and non-pharmacologically treated patients. Conclusion: HUT can be safely performed with a high specificity in children, with the sensitivity of HUT improved by isoproterenol. Therefore, a positive response to treatment is reassuring to the physician and family. NCS is generally a self-limited condition despite a high recurrence rate. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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