Impact of intracardiac electrophysiologic testing on the management of elderly patients with recurrent syncope or near syncope

D. D. Sugrue, David Holmes, B. J. Gersh, D. L. Wood, M. J. Osborn, S. C. Hammill

Research output: Contribution to journalArticle

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Abstract

Seventy-five patients, 75 years of age and over, experienced recurrent syncope, with the etiology remaining unclear but presumably cardiogenic, after cardiac and neurologic examinations and noninvasive laboratory testing (including an electrocardiogram and ambulatory electrocardiographic monitoring). The mean number of previous syncopal spells was 14 (range, 1 to 64) over a mean of 36 months (range, 1 to 480 months). These patients underwent invasive electrophysiologic testing and a potential cause for syncope was identified in 68%. Abnormal findings at electrophysiologic testing included: sinus node dysfunction (55%); abnormal His-bundle conduction (39%); and ventricular tachycardia (14%), with some patients having more than one abnormality. No major complicaions were associated with the electrophysiologic testing. Patients were subsequently treated with permanent cardiac pacing or antiarrhythmic drugs or both, depending upon results of the electrophysiologic study. Follow-up examinations (mean of 26 months; range, 1 to 70) were possible in 90% of patients. No further syncope occurred in 84% of patients with an abnormal electrophysiologic study who received subsequent therapy to prevent the identified abnormality. Thus, in this difficult group of patients with recurrent syncope of uncertain etiology, electrophysiologic testing was safe and indicated abnormalities of conduction or rhythm in 68% of patients; treatment to correct these abnormalities prevented recurrent syncope in 84%.

Original languageEnglish (US)
Pages (from-to)1079-1083
Number of pages5
JournalJournal of the American Geriatrics Society
Volume35
Issue number12
StatePublished - 1987

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Syncope
Sick Sinus Syndrome
Bundle of His
Ambulatory Electrocardiography
Anti-Arrhythmia Agents
Neurologic Examination
Ventricular Tachycardia
Electrocardiography
Therapeutics

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Impact of intracardiac electrophysiologic testing on the management of elderly patients with recurrent syncope or near syncope. / Sugrue, D. D.; Holmes, David; Gersh, B. J.; Wood, D. L.; Osborn, M. J.; Hammill, S. C.

In: Journal of the American Geriatrics Society, Vol. 35, No. 12, 1987, p. 1079-1083.

Research output: Contribution to journalArticle

Sugrue, D. D. ; Holmes, David ; Gersh, B. J. ; Wood, D. L. ; Osborn, M. J. ; Hammill, S. C. / Impact of intracardiac electrophysiologic testing on the management of elderly patients with recurrent syncope or near syncope. In: Journal of the American Geriatrics Society. 1987 ; Vol. 35, No. 12. pp. 1079-1083.
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