Vasovagal Syncope: A Review of Current and Emerging Therapies for a Common Cardiology Condition

Masih Tajdini; Amir Hossein Behnoush; Amirmohammad Khalaji; Satish R Raj

doi:10.18502/jthc.v19i1.15529

Masih Tajdini Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Amir Hossein Behnoush Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Amirmohammad Khalaji Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Satish R Raj Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

DOI: https://doi.org/10.18502/jthc.v19i1.15529

Keywords: Vasovagal Syncope; Diagnosis; Syncope; Therapeutics

Abstract

Vasovagal syncope (VVS), characterized by transient loss of consciousness, is among the most prevalent reasons for emergency visits worldwide. Although benign in nature, VVS can be accompanied by traumatic injury, leading to morbidity and decreased quality of life, especially in those with VVS recurrence. The management includes non-pharmacologic and pharmacologic therapies (if resistant), patient education and reassurance, salt and fluid intake increase, and physical counter-pressure maneuvers. Among medications, midodrine has shown promising results in reducing VVS recurrence and positive head-up tilt tests. Fluoxetine and atomoxetine also might be suitable candidates for VVS therapy. Permanent pacemakers, such as closed-loop stimulation, are under research and can be effective in cases unresponsive to medical treatment. In summary, while data are scarce regarding the definite treatment of VVS, there is a need for further research with novel, easy-to-use and cost-effective therapeutic methods to enhance quality of life and prevent traumatic injury.