[Update ESC Guideline Syncope 2018]
Lukas Clasen1, Hisaki Makimoto1, Wolfgang von Scheidt2
1Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf.
Insights
The 2018 ESC Guidelines update syncope diagnosis and management, emphasizing risk stratification in emergency departments and introducing new monitoring strategies. These guidelines also refine treatment algorithms and recommend specialized syncope units for better patient care.
Area of Science:
- Cardiology
- Emergency Medicine
Background:
- Syncope is a common reason for emergency department visits.
- Diverse causes and economic factors necessitate clear diagnostic and admission protocols for syncope patients.
Purpose of the Study:
- To summarize the key updates in the 2018 European Society of Cardiology (ESC) Guidelines for the diagnosis and management of syncope.
- To highlight changes in risk stratification, diagnostic pathways, and therapeutic recommendations.
Main Methods:
- Review and synthesis of the 2018 ESC Guidelines.
- Focus on updated recommendations for emergency department assessment, risk stratification, and patient monitoring.
- Analysis of modifications to treatment algorithms for reflex syncope and device implantation indications.
Main Results:
- The 2018 guidelines maintain unchanged syncope definitions but introduce updated risk stratification in emergency departments.
- Clearer diagnostic pathways and monitoring using portable devices are recommended.
- Modified algorithms for reflex syncope therapy and device indications (pacemakers, implantable cardioverter-defibrillators) for high-risk patients.
Conclusions:
- The updated guidelines provide a modern framework for syncope management, integrating risk assessment and technology.
- Establishment of multidisciplinary "syncope-units" is recommended for optimal patient care and outcomes.
Abstract:
Syncope is one of the most frequent mode of hospital visits in the emergency department. A broad range of causalities and healthcare economic efficiency have demanded reasonable road maps for diagnostic procedures and hospital admission of patients with syncope. Recent advances and multidisciplinary assessments provided the basis of the updated 2018 ESC Guidelines for the diagnosis and management of syncope. While the definitions of syncope remain unchanged these updates state risk stratification in the emergency department with clear diagnostic paths and monitoring in the current era with portable devices. The algorithm for reflex syncope therapy, indication for cardiac pacemakers and implantable cardioverter-defibrillators in high-risk patients for sudden cardiac death were modified. Finally, the updated guidelines recommend an establishment of "syncope-unit" with multidisciplinary involvement.
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