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30-09-2023 | Vasovagal Syncope | Research Article

Characteristics of deceleration capacity and deceleration runs in vasovagal syncope

Authors: Jiakun Li, Wei Sun, Xu Yang, Bin Tu, Simin Cai, Feng Hu, Zhiyuan Weng, Shangyu Liu, Zihao Lai, Lihui Zheng, Yan Yao

Published in: Clinical Autonomic Research | Issue 1/2024

Abstract

Purpose

Increased vagal activity plays a prominent role in vasovagal syncope (VVS). The aim of this study was to characterize vagal function in VVS by evaluating the heart rate (HR) deceleration capacity (DC) and the HR deceleration runs (DRs) in patients with VVS between attacks.

Methods

A total of 188 consecutive VVS patients were enrolled in the study, of whom 129 had positive head-up tilt test (HUTT); 132 healthy participants were enrolled as controls. DC, DRs (DR2, i.e., episodes of 2 consecutive beat-to-beat HR decelerations), and the sum of DR8-10 (very long DR [VLDR]) were calculated using 24-h electrograms. Clinical characteristics, DC, and DRs were compared among syncope groups and controls.

Results

Patients with VVS had higher DC (10.63 ± 2.1 vs. 6.58 ± 1.7 ms; P < 0.001) and lower minimum HR and DR6-10 than controls. No significant differences in DC or DR6-10 were found between the patients with positive and those with negative HUTT results. In multivariate logistic regression analysis, minimum HR ≥ 40 bpm (odds ratio [OR] 0.408, 95% confidence interval [CI] 0.167–0.989; P = 0.048), daytime DC ≥ 7.37 ms (OR 3.040, 95% CI 1.220–7.576; P = 0.013), and VLDR ≥ 0.046% (OR 0.306, 95% CI 0.138–0.679; P = 0.004) were demonstrated to be risk factors significantly associated with VVS.

Conclusion

Compared to healthy controls, patients with VVS demonstrated distinct HR deceleration profiles between attacks, including overall higher DC and lower DR6-10.

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Title: Characteristics of deceleration capacity and deceleration runs in vasovagal syncope
Authors: Jiakun Li
Wei Sun
Xu Yang
Bin Tu
Simin Cai
Feng Hu
Zhiyuan Weng
Shangyu Liu
Zihao Lai
Lihui Zheng
Yan Yao
Publication date: 30-09-2023
Publisher: Springer Berlin Heidelberg
Keyword: Vasovagal Syncope
Published in: Clinical Autonomic Research / Issue 1/2024
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-023-00989-z

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Springer Medicine

Characteristics of deceleration capacity and deceleration runs in vasovagal syncope

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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