Original ArticlePrevalence and Clinical Outcomes of Patients With Multiple Potential Causes of Syncope
Section snippets
Patient Accrual
All patients who were referred to the electrophysiology service for the evaluation of syncope at the Mayo Clinic in Rochester, Minn, from January 1, 1996, through December 31, 1998, were retrospectively identified and included in the study. These patients were referred from Mayo Clinic outpatient clinics, inpatient services, and hospital emergency departments and from other institutions. They were referred because, after an initial evaluation that included a history, physical examination,
Patient Characteristics
From January 1, 1996, through December 31, 1998, 3942 patients were evaluated at the Mayo Clinic for syncope. Of these, 1043 consecutive patients were referred to the electrophysiology service; 987 patients met study criteria, consented to having their charts reviewed, and were included in the analysis. The mean ± SD age was 58.0±21.4 years; 550 patients (55.7%) were male (Table 1).
Syncope Evaluation
Of the total 987 patients, 228 (23.1%) had electrophysiologic testing, 493 (49.9%) had table tilt testing, and 266
Major Findings
In this retrospective cohort study of 987 patients, the major findings were as follows: (1) multiple potential causes of syncope occurred in 18.4% of the patients; (2) multiple potential causes correlated with increased mortality; (3) patients with multiple potential causes had a greater recurrence rate, although this was not statistically significant; (4) older age, atrial fibrillation, use of cardiac medications, and New York Heart Association classification II, III, and IV were independent
CONCLUSION
This study emphasizes that syncope from multiple potential causes is a common phenomenon, especially in the elderly population. These patients also tend to have a greater mortality risk. Future research on therapeutic interventions and clinical outcomes is warranted with the aim of reducing recurrent symptoms and improving survival in patients who have multiple potential causes of syncope.
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