The ventricular late potentials in children with vasodepressor response of vasovagal syncope

Research progress on the predictive value of electrocardiographic indicators in the diagnosis and prognosis of children with vasovagal syncope

Neurally mediated syncope (NMS) is a common type of syncope in children in clinical practice, among which vasovagal syncope (VVS) is the most frequent. In recent years, more and more studies have been carried out to assess the diagnosis and prognosis of VVS. The electrocardiographic indicators such as heart rate variability (HRV), QT dispersion (QTd), P-wave dispersion (Pd), ventricular late potentials (VLP), deceleration ability of heart rate (DC), etc., are easy to obtain and inexpensive. With the help of electrocardiographic indicators, the diagnostic procedure and individualized treatment strategies of pediatric VVS can be optimized. This article reviews the value of electrocardiographic indicators in the diagnosis and prognosis of children with VVS.

Clinical values of creatine kinase and its isoenzymes in children and adolescents with vasovagal syncope

BACKGROUND AND AIM

Vasovagal syncope (VVS) in children and adolescents is a common disorder. There may be an internal relationship between creatine kinase (CK) and its isoenzymes (CKMB) and syncope. The aim of this study was to evaluate the changes of CK and CKMB in children and adolescents with VVS.

METHODS AND RESULTS

The VVS group included 218 patients (93 male and 125 female). The control group included 129 healthy children (78 male and 51 female). Serum CK and CKMB levels were estimated. We founded ①Serum CK and CK-MB levels decreased in VVS group than that in control group (P < 0.05). ②The CK levels of female were significantly lower than those of male in VVS group (P < 0.05). ③Serum level of CK-MB were in negative correlation with age, height, weight, BMI whereas in positively correlation with HR. ④CK was effected by CK-MB (β = 0.147, P = 0.037) while CK-MB was independently influenced by age (β = -0.203, P = 0.002) and DBP (β = 0.171, P = 0.011). ⑤Both CK and CK-MB significantly influenced on VVS occurrence after adjusting for the effects of gender, age, height, weight, BMI and HR.

CONCLUSION

The serum CK and CKMB levels decrease in children and adolescents with VVS. CK and CK-MB are the independent protective factors with VVS.

The clinical characteristics of situational syncope in children and adults undergoing head-up tilt testing

OBJECTIVE

Situational syncope is a subtype of neurally mediated syncope and associated with specific circumstances. This paper is to assess the clinical characteristics and underlying causes of situational syncope.

METHODS

This is a retrospective study of patients who underwent head-up tilt testing (HUTT). Medical records including age at HUTT, gender, number of syncopal episodes, family history of syncope, triggers before the syncopal episode, position during the syncopal episode and the responses to HUTT were reviewed.

RESULTS

Among 3140 patients, 354 patients (mean age 28.3 ± 16.6 years old, with 184 males and 170 females) were diagnosed with situational syncope. The causes of situational syncope included micturition (50.85%), defecation (15.82%), bathing (10.45%), swallowing (6.50%), cough (4.80%), post-dinner (3.95%), singing (3.11%), teeth brushing (2.26%), and hair grooming (2.26%). Patients with syncope triggered by micturition, cough, post-dinner were more likely to be men, while those caused by bathing, swallowing, singing, teeth brushing and hair grooming were more likely to be women. 34.75% of patients with situational syncope were between the ages of 10-19 years old, and 20.34% were between the ages of 40-49 years old. 74.01% of situational syncopal events occurred in an upright position. 47.74% of patients had positive responses to HUTT.

CONCLUSIONS

These findings show that micturition was the most common cause of situational syncope in both children and adults. There were significant gender and age differences among situational syncope triggered by different causes. Most of situational syncope occurred in the upright position and nearly half of the patients had positive responses to HUTT.