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Is Home Orthostatic Self‐Training Effective in Preventing Neurally Mediated Syncope?
Author(s) -
ON YOUNG KEUN,
PARK JUNGWAE,
HUH JUNE,
SOO KIM JUNE
Publication year - 2007
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.1540-8159.2007.00725.x
Subject(s) - medicine , orthostatic vital signs , presyncope , tilt table test , syncope (phonology) , physical therapy , tilt (camera) , randomized controlled trial , heart rate , anesthesia , physical medicine and rehabilitation , blood pressure , mechanical engineering , engineering
Background:Repeated orthostatic stress may prove to be of benefit in the regulation of neurally mediated syncope. But the role of home orthostatic self‐training is not established to prevent symptoms in patients with neurally mediated syncope. We performed a prospective and randomized study to evaluate the effectiveness of repeated home orthostatic self‐training in preventing tilt‐induced neurally mediated syncope.Methods and Results:Fourty‐two consecutive patients (24 males and 18 females, mean age 39 years, 16–68 years) with recurrent neurally mediated syncope were randomized into the tilt training and control groups. The home orthostatic self‐training program consisted of daily sessions for 7 days a week for 4 weeks. In order to determine the effects of home orthostatic self‐training, we repeated the head‐up tilt test in both groups 4 weeks later. Among the tilt‐training group, 9 of 16 patients (56%) had a positive response on follow‐up head‐up tilt test. Among the untreated control group, 9 of 17 patients (53%) had a positive response on follow‐up head‐up tilt test. In subgroup analyses according to the number of tilt‐training sessions or the classified type, we found no differences in the follow‐up head‐up tilt test responses. Spontaneous syncope or presyncope over mean follow‐up of 16.9 months were observed in 42.9% versus 47.1% in the tilt‐training and control group, respectively.Conclusions:Home orthostatic self‐training was ineffective in reducing the positive response rate of head‐up tilt test in patients with recurrent neurally mediated syncope.