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Autonomic Nervous System Changes in Vasovagal Syncope:
Author(s) -
KOCHIADAKIS GEORGE E.,
PAPADIMITRIOU EVANGELOS A.,
MARKETOU MARY E.,
CHRYSOSTOMAKIS STAVROS I.,
SIMANTIRAKIS EMMANUEL N.,
VARDAS PANOS E.
Publication year - 2004
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2004.00641.x
Subject(s) - vasovagal syncope , medicine , autonomic nervous system , syncope (phonology) , cardiology , heart rate variability , tilt table test , heart rate , pathophysiology , young adult , autonomic function , spectral analysis , anesthesia , age groups , blood pressure , physics , demography , quantum mechanics , sociology , spectroscopy
Spectral analysis of heart rate variability was used to compare the changes in autonomic function during tilting in young and older patients with vasovagal syncope. Twenty‐four young (age 28 ± 8 years) and 31 older (56 ± 5 years) patients with unexplained syncope and a positive tilt test and 25 controls (age 48 ± 12 years) were included in the study. Frequency‐domain measurements of the low (LF) (0.06–0.15 Hz) and high (HF) (0.15–0.40 Hz) frequency bands and the ratio of LF to HF were computed from Holter recordings for 4‐minute intervals before and immediately after tilting and just before the end in all groups. Syncopal patients showed a different pattern of response to tilting from controls in all spectral indexes. Young and older patients showed the same pattern of changes in all measurements, even though certain differences were observed. The LF after tilting reduced more in the older (‐20 ± 7% vs ‐14 ± 5%, P < 0.001), while HF reduced more in young patients (‐17 ± 8% vs ‐8 ± 3%, P < 0.001). Young patients showed mainly a cardioinhibitory type (71%) of response whereas a vasodepressor type response predominated (68%) in the older patients. The autonomic nervous system appears to play an important role in the pathophysiological mechanism of vasovagal syncope. This role is similar in young and in older patients and this should be taken into account in the therapeutic approach to the condition. Specific differences between age groups may be related to the type of vasovagal syncope.