Investigation And Analysis Of The Cause Of Syncope In A Single Center

Background Syncope is a common clinical symptom,and there are many reasons for syncope.At present,investigating the cause of syncope is facing many difficulties.The cause of syncope cannot be confirmed even after a series of examinations for lots of patients.Objective The purpose of this study is to investigate the state-of-art cause and treatment of hospitalized patients with syncope.Methods The study enrolled patients from September 2013 to December 2015 who were diagnosed with "syncope" in Fuwai hospital.Syncope is defined as transient loss of consciousness due to cerebral hypoperfusion,characterized by a rapid onset,short duration,and spontaneous complete recovery.Clinical baseline data,various examinations performed after admission,the confirmed cause of syncope and the status of treatmentwere collected for all patients.For patients with explained syncope,the proportions of the causes of syncope were analyzed.For patients with unexplained syncope,the results of syncope-related examinations during hospitalization were collected and analyzed.Results The study enrolled 569 hospitalized patients with syncope and finally included 540 patients for analysis.The mean age of patients was 55.92±16.27 years,56.9%patients were males,and the average number of syncope was 2.38±2.49.Before discharge,the cause of syncope was found for 59.1%patient.Neurally mediated syncope is the most common cause(33.3%),in which vasovagal syncope accounted for 29.6%,cough syncope,postural syncope,and urinary syncope were relatively low(0.9%,0.6%and 2.2%).55%of vasovagal syncope and all other neurally mediated syncope were treated by health education and lifestyle change to prevent syncope.8.8%and 10.6%of patients with vasovagal syncope were implanted with pacemaker or treated by vaginal modified ablation,respectively.The cardiogenic syncope(26.5%),mainly bradyarrhythmia(3 5.5%)or tachyarrhythmia(31.9%)related syncope,treated with implanted pacemaker or radiofrequency ablation.In this study,40.9%of hospitalized patients had not confirmed the cause of syncope after various examinations.These patients have an average age of 59.31±13.62 years,135 of them were males(61.1%),and the average number of received syncope-related examinations were 3.53±1.48.Conclusions This study shows that the cause can be clearly diagnosed for most of patients with syncope.The vasovagal syncope in neuroreflex syncope is the most common cause of syncope.Most patients are treated with health education and lifestyle adjustment.Some patients undergo vagal ablation and implantable pacemaker therapy.Cardiac syncope is more common with syncope caused by bradyarrhythmia.The cause of unexplained syncope after hospitalization has not been identified after various examinations,requiring multidisciplinary cooperation and long-term ECG monitoring.