Does syncope require rhythmic and non-rhythmic evaluation in patients with previous MI?
BackgroundMultiple factors, in addition to left ventricular ejection fraction (LVEF) influence the risk of mortality in coronary artery disease. The purpose of this study was to evaluate the main causes of syncope after myocardial infarction (MI) and to propose an algorithm of management.Methods356...
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| Veröffentlicht in: | Heart Asia 2010-01, Vol.2 (1), p.56-61 |
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| creator | Brembilla-Perrot, B Suty-Selton, C Alla, F Zinzius, P Y Blangy, H Azman, B Terrier de la Chaise, A Louis, P Groben, L Djaballah, K Selton, O Magalhaes, S Muresan, L Cedano, J Abdelaal, A Sadoul, N |
| description | BackgroundMultiple factors, in addition to left ventricular ejection fraction (LVEF) influence the risk of mortality in coronary artery disease. The purpose of this study was to evaluate the main causes of syncope after myocardial infarction (MI) and to propose an algorithm of management.Methods356 patients consecutively admitted for syncope and history of MI (>1 month), without ventricular tachycardia (VT), underwent echocardiography, Holter monitoring, head-up tilt test, exercise testing, signal-averaged ECG, electrophysiological study (EPS) and evaluation of coronary status. The mean follow-up was 4±2 years.ResultsMonomorphic VT, ventricular flutter or fibrillation (VF) and supraventricular tachyarrhythmia were respectively induced at EPS in 87, 63 and 39 patients; conduction disturbances were noted in 23 patients, and 57 patients had several abnormalities. Among the 144 patients with negative EPS, coronary ischaemia was identified in 37 patients, and hypervagotonia in 27 patients. All studies remain negative in 84 patients (23.6%), more frequently women (p |
| doi_str_mv | 10.1136/ha.2009.001602 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4898518</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1798999297</sourcerecordid><originalsourceid>FETCH-LOGICAL-b337t-46c968f44408f7bd8f796bd526d1749c11087c67adf552f14ad675426b5d524c3</originalsourceid><addsrcrecordid>eNqFkc1PHCEYxolpo0a9ejQkXtrDrMAwfFw0RttqYtNLG4-EYRiHzQyMMLPN_veyWbtRL-XA-wZ-PHleHgBOMVpgXLKLTi8IQnKBEGaI7IFDzCtZYIzopzf9AThJaYnyKjEVlOyDA8JLUklKD8HjbbAJprU3YbQw2ufZxVy79dQNzkDtG-iDL3YHdqX7WU8ueOg8HHNn_ZTgXzd1cIx25cKc4M_7q2PwudV9siev9Qj8-f7t981d8fDrx_3N9UNRlyWfCsqMZKKllCLR8rrJm2R1UxHWYE6lyf4FN4zrpq0q0mKqG8YrSlhdZYia8ghcbnXHuR5sY7KbqHs1RjfouFZBO_X-xrtOPYWVokKKCoss8OVVIIbn2aZJDS4Z2_fa2zyLwlwKKSWRPKPnH9BlmKPP42VKsM1fyzJTiy1lYkgp2nZnBiO1iU11Wm1iU9vY8oOztyPs8H8hZeDrFqiH5f_EXgBbrZ9w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1786110493</pqid></control><display><type>article</type><title>Does syncope require rhythmic and non-rhythmic evaluation in patients with previous MI?</title><source>BMJ Journals - NESLi2</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Brembilla-Perrot, B ; Suty-Selton, C ; Alla, F ; Zinzius, P Y ; Blangy, H ; Azman, B ; Terrier de la Chaise, A ; Louis, P ; Groben, L ; Djaballah, K ; Selton, O ; Magalhaes, S ; Muresan, L ; Cedano, J ; Abdelaal, A ; Sadoul, N</creator><creatorcontrib>Brembilla-Perrot, B ; Suty-Selton, C ; Alla, F ; Zinzius, P Y ; Blangy, H ; Azman, B ; Terrier de la Chaise, A ; Louis, P ; Groben, L ; Djaballah, K ; Selton, O ; Magalhaes, S ; Muresan, L ; Cedano, J ; Abdelaal, A ; Sadoul, N</creatorcontrib><description>BackgroundMultiple factors, in addition to left ventricular ejection fraction (LVEF) influence the risk of mortality in coronary artery disease. The purpose of this study was to evaluate the main causes of syncope after myocardial infarction (MI) and to propose an algorithm of management.Methods356 patients consecutively admitted for syncope and history of MI (>1 month), without ventricular tachycardia (VT), underwent echocardiography, Holter monitoring, head-up tilt test, exercise testing, signal-averaged ECG, electrophysiological study (EPS) and evaluation of coronary status. The mean follow-up was 4±2 years.ResultsMonomorphic VT, ventricular flutter or fibrillation (VF) and supraventricular tachyarrhythmia were respectively induced at EPS in 87, 63 and 39 patients; conduction disturbances were noted in 23 patients, and 57 patients had several abnormalities. Among the 144 patients with negative EPS, coronary ischaemia was identified in 37 patients, and hypervagotonia in 27 patients. All studies remain negative in 84 patients (23.6%), more frequently women (p<0.001). Four patients died suddenly during follow-up. A longer QRS duration, a lower LVEF and grade IVa,b of Lown on Holter ECG were associated with the induction of VT. LVEF<40% and VT/VF induction were predictors of cardiac mortality, VT was a predictor of sudden death, and low LVEF and advanced age were predictors of death by heart failure.ConclusionMyocardial ischaemia, hypervagotonia, conduction abnormalities, ventricular or supraventricular tachyarrhythmias were identified in 76% of patients with syncope after MI. Several factors of syncope were found in 57 patients (16%). Non-invasive rhythmological and systematic coronary status assessment should be recommended in patients with syncope following MI.</description><identifier>ISSN: 1759-1104</identifier><identifier>EISSN: 1759-1104</identifier><identifier>DOI: 10.1136/ha.2009.001602</identifier><identifier>PMID: 27325944</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Original Research</subject><ispartof>Heart Asia, 2010-01, Vol.2 (1), p.56-61</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898518/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898518/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27325944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brembilla-Perrot, B</creatorcontrib><creatorcontrib>Suty-Selton, C</creatorcontrib><creatorcontrib>Alla, F</creatorcontrib><creatorcontrib>Zinzius, P Y</creatorcontrib><creatorcontrib>Blangy, H</creatorcontrib><creatorcontrib>Azman, B</creatorcontrib><creatorcontrib>Terrier de la Chaise, A</creatorcontrib><creatorcontrib>Louis, P</creatorcontrib><creatorcontrib>Groben, L</creatorcontrib><creatorcontrib>Djaballah, K</creatorcontrib><creatorcontrib>Selton, O</creatorcontrib><creatorcontrib>Magalhaes, S</creatorcontrib><creatorcontrib>Muresan, L</creatorcontrib><creatorcontrib>Cedano, J</creatorcontrib><creatorcontrib>Abdelaal, A</creatorcontrib><creatorcontrib>Sadoul, N</creatorcontrib><title>Does syncope require rhythmic and non-rhythmic evaluation in patients with previous MI?</title><title>Heart Asia</title><addtitle>Heart Asia</addtitle><description>BackgroundMultiple factors, in addition to left ventricular ejection fraction (LVEF) influence the risk of mortality in coronary artery disease. The purpose of this study was to evaluate the main causes of syncope after myocardial infarction (MI) and to propose an algorithm of management.Methods356 patients consecutively admitted for syncope and history of MI (>1 month), without ventricular tachycardia (VT), underwent echocardiography, Holter monitoring, head-up tilt test, exercise testing, signal-averaged ECG, electrophysiological study (EPS) and evaluation of coronary status. The mean follow-up was 4±2 years.ResultsMonomorphic VT, ventricular flutter or fibrillation (VF) and supraventricular tachyarrhythmia were respectively induced at EPS in 87, 63 and 39 patients; conduction disturbances were noted in 23 patients, and 57 patients had several abnormalities. Among the 144 patients with negative EPS, coronary ischaemia was identified in 37 patients, and hypervagotonia in 27 patients. All studies remain negative in 84 patients (23.6%), more frequently women (p<0.001). Four patients died suddenly during follow-up. A longer QRS duration, a lower LVEF and grade IVa,b of Lown on Holter ECG were associated with the induction of VT. LVEF<40% and VT/VF induction were predictors of cardiac mortality, VT was a predictor of sudden death, and low LVEF and advanced age were predictors of death by heart failure.ConclusionMyocardial ischaemia, hypervagotonia, conduction abnormalities, ventricular or supraventricular tachyarrhythmias were identified in 76% of patients with syncope after MI. Several factors of syncope were found in 57 patients (16%). Non-invasive rhythmological and systematic coronary status assessment should be recommended in patients with syncope following MI.</description><subject>Original Research</subject><issn>1759-1104</issn><issn>1759-1104</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNqFkc1PHCEYxolpo0a9ejQkXtrDrMAwfFw0RttqYtNLG4-EYRiHzQyMMLPN_veyWbtRL-XA-wZ-PHleHgBOMVpgXLKLTi8IQnKBEGaI7IFDzCtZYIzopzf9AThJaYnyKjEVlOyDA8JLUklKD8HjbbAJprU3YbQw2ufZxVy79dQNzkDtG-iDL3YHdqX7WU8ueOg8HHNn_ZTgXzd1cIx25cKc4M_7q2PwudV9siev9Qj8-f7t981d8fDrx_3N9UNRlyWfCsqMZKKllCLR8rrJm2R1UxHWYE6lyf4FN4zrpq0q0mKqG8YrSlhdZYia8ghcbnXHuR5sY7KbqHs1RjfouFZBO_X-xrtOPYWVokKKCoss8OVVIIbn2aZJDS4Z2_fa2zyLwlwKKSWRPKPnH9BlmKPP42VKsM1fyzJTiy1lYkgp2nZnBiO1iU11Wm1iU9vY8oOztyPs8H8hZeDrFqiH5f_EXgBbrZ9w</recordid><startdate>20100101</startdate><enddate>20100101</enddate><creator>Brembilla-Perrot, B</creator><creator>Suty-Selton, C</creator><creator>Alla, F</creator><creator>Zinzius, P Y</creator><creator>Blangy, H</creator><creator>Azman, B</creator><creator>Terrier de la Chaise, A</creator><creator>Louis, P</creator><creator>Groben, L</creator><creator>Djaballah, K</creator><creator>Selton, O</creator><creator>Magalhaes, S</creator><creator>Muresan, L</creator><creator>Cedano, J</creator><creator>Abdelaal, A</creator><creator>Sadoul, N</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100101</creationdate><title>Does syncope require rhythmic and non-rhythmic evaluation in patients with previous MI?</title><author>Brembilla-Perrot, B ; Suty-Selton, C ; Alla, F ; Zinzius, P Y ; Blangy, H ; Azman, B ; Terrier de la Chaise, A ; Louis, P ; Groben, L ; Djaballah, K ; Selton, O ; Magalhaes, S ; Muresan, L ; Cedano, J ; Abdelaal, A ; Sadoul, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b337t-46c968f44408f7bd8f796bd526d1749c11087c67adf552f14ad675426b5d524c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Original Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brembilla-Perrot, B</creatorcontrib><creatorcontrib>Suty-Selton, C</creatorcontrib><creatorcontrib>Alla, F</creatorcontrib><creatorcontrib>Zinzius, P Y</creatorcontrib><creatorcontrib>Blangy, H</creatorcontrib><creatorcontrib>Azman, B</creatorcontrib><creatorcontrib>Terrier de la Chaise, A</creatorcontrib><creatorcontrib>Louis, P</creatorcontrib><creatorcontrib>Groben, L</creatorcontrib><creatorcontrib>Djaballah, K</creatorcontrib><creatorcontrib>Selton, O</creatorcontrib><creatorcontrib>Magalhaes, S</creatorcontrib><creatorcontrib>Muresan, L</creatorcontrib><creatorcontrib>Cedano, J</creatorcontrib><creatorcontrib>Abdelaal, A</creatorcontrib><creatorcontrib>Sadoul, N</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Psychology</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Heart Asia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brembilla-Perrot, B</au><au>Suty-Selton, C</au><au>Alla, F</au><au>Zinzius, P Y</au><au>Blangy, H</au><au>Azman, B</au><au>Terrier de la Chaise, A</au><au>Louis, P</au><au>Groben, L</au><au>Djaballah, K</au><au>Selton, O</au><au>Magalhaes, S</au><au>Muresan, L</au><au>Cedano, J</au><au>Abdelaal, A</au><au>Sadoul, N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does syncope require rhythmic and non-rhythmic evaluation in patients with previous MI?</atitle><jtitle>Heart Asia</jtitle><addtitle>Heart Asia</addtitle><date>2010-01-01</date><risdate>2010</risdate><volume>2</volume><issue>1</issue><spage>56</spage><epage>61</epage><pages>56-61</pages><issn>1759-1104</issn><eissn>1759-1104</eissn><abstract>BackgroundMultiple factors, in addition to left ventricular ejection fraction (LVEF) influence the risk of mortality in coronary artery disease. The purpose of this study was to evaluate the main causes of syncope after myocardial infarction (MI) and to propose an algorithm of management.Methods356 patients consecutively admitted for syncope and history of MI (>1 month), without ventricular tachycardia (VT), underwent echocardiography, Holter monitoring, head-up tilt test, exercise testing, signal-averaged ECG, electrophysiological study (EPS) and evaluation of coronary status. The mean follow-up was 4±2 years.ResultsMonomorphic VT, ventricular flutter or fibrillation (VF) and supraventricular tachyarrhythmia were respectively induced at EPS in 87, 63 and 39 patients; conduction disturbances were noted in 23 patients, and 57 patients had several abnormalities. Among the 144 patients with negative EPS, coronary ischaemia was identified in 37 patients, and hypervagotonia in 27 patients. All studies remain negative in 84 patients (23.6%), more frequently women (p<0.001). Four patients died suddenly during follow-up. A longer QRS duration, a lower LVEF and grade IVa,b of Lown on Holter ECG were associated with the induction of VT. LVEF<40% and VT/VF induction were predictors of cardiac mortality, VT was a predictor of sudden death, and low LVEF and advanced age were predictors of death by heart failure.ConclusionMyocardial ischaemia, hypervagotonia, conduction abnormalities, ventricular or supraventricular tachyarrhythmias were identified in 76% of patients with syncope after MI. Several factors of syncope were found in 57 patients (16%). Non-invasive rhythmological and systematic coronary status assessment should be recommended in patients with syncope following MI.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27325944</pmid><doi>10.1136/ha.2009.001602</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Original Research |
| title | Does syncope require rhythmic and non-rhythmic evaluation in patients with previous MI? |
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