Eastbourne Syncope Assessment Study II

Launched by EASTBOURNE GENERAL HOSPITAL · Aug 15, 2007

Keywords

ClinConnect Summary

The original EaSyAS study (1998) evaluated the use of implantable loop recorders (ILRs) in the diagnosis and management of syncope.This demonstrated a significant increase in successful diagnosis following use of implantable loop recorders. Here there were 442 syncope admissions to Eastbourne in 2001. Diagnostic rate was 42%. In addition, time to diagnosis was quicker and therefore so was introduction of therapy. This resulted in significant increase in time to recurrent syncopal episodes and improved general wellbeing in an unselected population with syncope of an unknown cause.

The "Post...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age \> = 16 yrs
• • Acute syncope presentation to MAU or A+E
• • 2 or more unexplained syncopes within the past 24 months including index episode
• • Normal baseline ECG
• • Absence of co - existing pathology requiring admission
• Exclusion Criteria:
• • Suspected or known heart disease
• • ECG abnormalities suspected of arrhythmic syncope listed in Table 1
• • Syncope occurring during exercise
• • Syncope causing severe injury
• • Family history of sudden death
• • Sudden onset palpitations prior to syncope
• Table 1: ECG Abnormalities:
• • Bifascicular block (defined as LBBB or RBBB combined with left anterior or left posterior fascicular block)
• • Other intraventricular abnormalities (QRS duration \>= 0.12s)
• • Mobitz 1 second degree AV block (Wenckebach)
• • Asymptomatic sinus bradycardia (\<50 bpm), SA node or sinus pause \>= 3s in the absence of negatively chronotropic medications
• • Pre-excited QRS with short PR interval (WPW)
• • Significantly Prolonged QT interval
• • RBBB pattern with ST elevation in V1 - V3 (Brugada Syndrome)
• • Negative T waves with ST segment elevation in right precordial leads suggestive of arrythmogenic right ventricular dysplasia
• • Significant Q waves (\>= 0.02s) suggestive of MI