The The effect of education in preventing recurrent vasovagal syncope

Abstract

Although vasovagal syncope is a common type of syncope, its treatment has not been well established. We evaluated the long-term efficacy of education in preventing recurrent vasovagal syncope compared with drug treatment. We retrospectively investigated a total of 422 patients who were diagnosed with vasovagal syncope from June 2007 to October 2009. Group 1 (n=213, 50.5%) was treated with education alone. Group 2 (n=209, 49.5%) received education plus medication; β-blockers (n=132, 63%), midodrine (n=71, 34%), and selective serotonin reuptake inhibitors (n=6, 3%). All patients were educated about lying down at the onset of prodromal symptoms, avoiding triggering events, and modifying their lifestyle. Patients were regularly followed up at an outpatient clinic or by phone for 2.43 ± 0.03 years. During follow-up, the frequency of syncopal episodes per year (n/year) following treatment reduced from 1.66 ± 1.11 to 0.06 ± 0.37 in group 1, and from 1.50 ± 1.18 to 0.07 ± 0.23 in group 2. In multiple logistic regression analysis in matched groups according to propensity score, young age < 35 years (odds ratio [OR] 2.18, 95 confidence interval [CI] 1.03-4.64, p=0.042), and frequent previous syncopal episodes/year > 2.08 (OR 2.11, CI 1.26-4.22, p=0.034) remained significant as independent predictors associated with increased risk for recurrent vasovagal syncope, but treatment type was not related to recurrent vasovagal syncope. In conclusion, medication as a treatment for recurrent vasovagal syncope are not more effective than education.