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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2008, Number 3

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An Med Asoc Med Hosp ABC 2008; 53 (3)

Neurocardiogenic syncope in childhood. Current concepts diagnosis and treatment

Escalante MAM

Language: Spanish
References: 46
Page: 149-153
PDF size: 130.46 Kb.


ABSTRACT

A wide variety of pharmacologic agents are currently used for the prevention of recurrent neurocardiogenic syncope in children and adolescents. Significant advances in the understanding of this sincopal disorder have occurred in the past decade, and the list of medications recommended has changed, reflecting the evolving understanding of the pathophysiology. At the present time beta adrenergic receptor blockers, fludrocortisone, serotonine reuptake inhibitors and midodrine, appear to be favored treatment options. Ideally, specific therapy would be tailored to specific pathophysiologic mechanism. Unfortunately, at present, specific treatments based on those abnormalities have not been identified.


REFERENCES

  1. Lewis DA, Dhala A. Syncope in pediatric patients. Pediatr Clin N Am 1999; 46: 205-219.

  2. Mora CE, Jaramillo VC, Rodriguez DA. Características demográficas, clínicas y terapéuticas de pacientes pediátricos con prueba de mesa basculante. Rev Col Cardiol 2003; 11: 122-131.

  3. Lelonek M. Genetics in neurocardiogenic syncope. Przegl Lek 2006; 63 (12): 1310-1312

  4. Johnsrude CL. Current approach to pediatric syncope. Pediatr. Cardiol 2000; 21: 522-531

  5. European Society of Cardiology Task force in syncope, Guidelines on management of syncope. Euro Heart J 2001; 22 (15): 1256-306.

  6. Vlahos A, Meropi T, Christos S. Provocation of neurocardiogenic syncope during head –up tilt testing in children: Comparison between isoproterenol and nitroglycerin. Pediatrics 2007 119 (2): 419-425

  7. DiGirolamo E, Dilorio C, Leonzio L. Usefulness of a tilt training program for the prevention of refractory neurocardiogenic syncope in adolescents: A controlled study. Circulation 1999; 100: 1798-801.

  8. Reybroack T, Heidbüchel, H van de Werf F. Tilt training: A treatment for malignant and recurrent neurocardiogenic syncope. Pacing Clin Electrophysiol 2000; 23: 493-498.

  9. Martial M. Neurocardiogenic syncope in children. Pediatr Drugs 2003; 5 (5) 327-334.

  10. Grubb BP, Temesy-Armos P, Moore J. The use of head-upright tilt table testing in the evaluation and management of syncope in children and adolescents. Pacing Clin Electrophysiol 1992; 15: 742-748.

  11. Scott WA, Pongiglione G, Bromerg BI. Randomized comparison of atenolol and fludrocortisone acetate in the treatment of pediatric neurally mediated syncope. Am J Cardiol 1995; 76: 400-402.

  12. Bendit DG, Faby GJ, Lurie KG. Pharmacotherapy of neurally mediated syncope. Circulation 1999; 100: 1242-1248.

  13. Mahanonda N et al. Randomized double-blind placebo-controlled trial of oral atenolol in patients with unexplained syncope and positive upright tilt table results. Am Heart J 1995; 130: 1250-1253.

  14. Alboni P, Bondanelli M. Role of the serotonergic system in the genesis of vasovagal syncope. Europace 2000; 172-180.

  15. Grubb BP, Samoil D, Kosinski D. Use of sertraline hydrochloride in the treatment of refractory neurocardiogenic syncope in children and adolescents. J Am Coll Cardiol 1994; 24: 490-494.

  16. Lenk M, Alehan D, Ozme S. The role of serotonin re-uptake inhibitoris in preventing recurrent unexplained childhood syncope: A preliminary report. Eur J Pediatr 1997; 156: 747-750.

  17. Strieper MJ, Campbell RMJ. Efficacy of alpha-adrenergic agonist therapy for prevention of pediatric neurocardiogenic syncope. J Am Coll Cardiol 1999; 22: 594-597.

  18. Perez LA, Schweikert R. Usefulness of midodrine hydrochloride in patients with severely symptomatic neurocardiogenic syncope: A randomized control study. J Cardiovasc Electrophysiol 2001; 12: 935-938.

  19. Zhang Q, Du J. The efficacy of midodrina hydrochloride in the treatment of children with vasovagal syncope. J Pediatr 2006 149 (6): 777-780.

  20. Deal BJ, Strieper M, Scagliotti D. The medical therapy of cardioinhibitory syncope in pediatric patients. Pacing Clin Electrophysiol 1997; 20: 1759-1761.

  21. Massin MM. Diagnosis and treatment of vasovagal syncope in the child and adolescent. Arch Pediatr 1998; 5: 923-926.

  22. Marvin S, Julian M. Pathophysiology, diagnosis and treatment of orthostatic hypotension and vasovagal syncope. Cardiol Rev 2008; 16 (1).

  23. Kapoor WW. Is there an effective treatment for neurally mediated syncope? JAMA 2003; 289: 2272-2275.

  24. Lewis DA, Dhala A. Syncope in pediatric patients. Pediatr Clin N Am 1999; 46: 205-219.

  25. Mora CE, Jaramillo VC, Rodriguez DA. Características demográficas, clínicas y terapéuticas de pacientes pediátricos con prueba de mesa basculante. Rev Col Cardiol 2003; 11: 122-131.

  26. Lelonek M. Genetics in neurocardiogenic syncope. Przegl Lek 2006; 63 (12): 1310-1312

  27. Johnsrude CL. Current approach to pediatric syncope. Pediatr. Cardiol 2000; 21: 522-531

  28. European Society of Cardiology Task force in syncope, Guidelines on management of syncope. Euro Heart J 2001; 22 (15): 1256-306.

  29. Vlahos A, Meropi T, Christos S. Provocation of neurocardiogenic syncope during head –up tilt testing in children: Comparison between isoproterenol and nitroglycerin. Pediatrics 2007 119 (2): 419-425

  30. DiGirolamo E, Dilorio C, Leonzio L. Usefulness of a tilt training program for the prevention of refractory neurocardiogenic syncope in adolescents: A controlled study. Circulation 1999; 100: 1798-801.

  31. Reybroack T, Heidbüchel, H van de Werf F. Tilt training: A treatment for malignant and recurrent neurocardiogenic syncope. Pacing Clin Electrophysiol 2000; 23: 493-498.

  32. Martial M. Neurocardiogenic syncope in children. Pediatr Drugs 2003; 5 (5) 327-334.

  33. Grubb BP, Temesy-Armos P, Moore J. The use of head-upright tilt table testing in the evaluation and management of syncope in children and adolescents. Pacing Clin Electrophysiol 1992; 15: 742-748.

  34. Scott WA, Pongiglione G, Bromerg BI. Randomized comparison of atenolol and fludrocortisone acetate in the treatment of pediatric neurally mediated syncope. Am J Cardiol 1995; 76: 400-402.

  35. Bendit DG, Faby GJ, Lurie KG. Pharmacotherapy of neurally mediated syncope. Circulation 1999; 100: 1242-1248.

  36. Mahanonda N et al. Randomized double-blind placebo-controlled trial of oral atenolol in patients with unexplained syncope and positive upright tilt table results. Am Heart J 1995; 130: 1250-1253.

  37. Alboni P, Bondanelli M. Role of the serotonergic system in the genesis of vasovagal syncope. Europace 2000; 172-180.

  38. Grubb BP, Samoil D, Kosinski D. Use of sertraline hydrochloride in the treatment of refractory neurocardiogenic syncope in children and adolescents. J Am Coll Cardiol 1994; 24: 490-494.

  39. Lenk M, Alehan D, Ozme S. The role of serotonin re-uptake inhibitoris in preventing recurrent unexplained childhood syncope: A preliminary report. Eur J Pediatr 1997; 156: 747-750.

  40. Strieper MJ, Campbell RMJ. Efficacy of alpha-adrenergic agonist therapy for prevention of pediatric neurocardiogenic syncope. J Am Coll Cardiol 1999; 22: 594-597.

  41. Perez LA, Schweikert R. Usefulness of midodrine hydrochloride in patients with severely symptomatic neurocardiogenic syncope: A randomized control study. J Cardiovasc Electrophysiol 2001; 12: 935-938.

  42. Zhang Q, Du J. The efficacy of midodrina hydrochloride in the treatment of children with vasovagal syncope. J Pediatr 2006 149 (6): 777-780.

  43. Deal BJ, Strieper M, Scagliotti D. The medical therapy of cardioinhibitory syncope in pediatric patients. Pacing Clin Electrophysiol 1997; 20: 1759-1761.

  44. Massin MM. Diagnosis and treatment of vasovagal syncope in the child and adolescent. Arch Pediatr 1998; 5: 923-926.

  45. Marvin S, Julian M. Pathophysiology, diagnosis and treatment of orthostatic hypotension and vasovagal syncope. Cardiol Rev 2008; 16 (1).

  46. Kapoor WW. Is there an effective treatment for neurally mediated syncope? JAMA 2003; 289: 2272-2275.




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