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Syncope

Causes
Clinical features
Investigations
Therapy
Prognosis
Prognosis

Death is more likely with an abnormal ECG a particularly
  • frequent (> 10/ hour ) or repetitive (> 2 consecutive) premature ventricular contractions a
  • sinus pause > 2 sec a
Why?

Heart and renal failure and certain arrhythmias increase the risk of dying

Patient Prognostic Factor Outcome CER OR
(95% CI)
NNF+
(95% CI)
unexplained syncope a congestive heart failure
independent
death
at 2 years
16%
(11% to 20%)
4
(1.9 to 8.1)
4
(2 to 10)
  creatinine > 2.0 mg/dl
independent
    7.9
(3.3 to 18.9)
2
(2 to 4)
  frequent or repetitive PVCs
independent
    3.7
(1.8 to 7.5)
4
(2 to 11)
  sinus pause > 2 sec
independent
    3.3
(1.1 to 9.6)
4
(2 to 77)

Frequent or repetitive premature ventricular contractions increase the risk of sudden death

Patient Prognostic Factor Outcome CER OR
(95% CI)
NNF+
(95% CI)
unexplained syncope a frequent or repetitive PVCs
independent
sudden death
at 2 years
7%
(4% to 10%)
14.9
(4 to 55.7)
2
(1 to 6)
 

Expiry date: June 2004
Levels of Evidence used in grading these guides

Author   CM   Ball
Reviewer   W N   Kapoor
CAT Writers   CM   Ball , B   Phillips , CJ   Wotton