Long-term Follow-up Results of Tilt Training in Patients with Neurocardiogenic Syncope

Kim, Je Sang; Kim, June Soo; Kim, Sung Hea; Baek, Kyung Kee; Lee, Seon Mee; Park, Jung Wae; Choi, Jin Ho; Sung, Ji Dong; Lee, Sang Chol; Park, Seung Woo; Gwon, Hyun Cheol; Chun, Eun Seok; Kim, Duk Kyung; Lee, Sang Hoon; Hong, Kyung Pyo; Park, Jeong Euy

Abstract

BACKGROUND AND OBJECTIVES
Tilt training as a non pharmacological therapy was recently introduced to treat the patients with neurocardiogenic syncope. Tilt training has been known to prevent neurocardiogenic syncope by desensitizing abnormal autonomic reflex. Herein, the early effect of tilt training and the preventive effect on the relapse of syncope were studied during a long-term follow-up period.
SUBJECTS AND METHODS
Fifteen patients (11 males) who experienced recurrent syncope, despite drug treatment or were intolerant to drug treatment, among those diagnosed as neurocardiogenic syncope by the head-up tilt test at Samsung Medical Center between March 2000 and May 2003 were recruited. Each patient underwent tilt training after admission and was educated to continue self-tilt training after discharge. Data for recurrences after discharge were obtained via questionnaires on outpatient visits or by telephone interviews.
RESULTS
Eleven (73%) of the 15 who underwent tilt training on admission showed therapeutic effects. The mean follow-up period was 21+/-10 months (5-40 months). Only one patient was excluded due to follow-up loss. Ten of the above patients underwent training by themselves for an average of 4 months after discharge, and experience no relapse of syncope during the follow-up period.
CONCLUSION
Tilt training maintained its therapeutic effect during long-term follow-up. This could be a new treatment for patients non responsive or intolerant to medical therapy.