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Clinical Efficacy of Empirical Therapy in Children with Vasovagal Syncope

Chunyan Tao1,2, Yaxi Cui1, Chunyu Zhang1

  • 1Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

Children (Basel, Switzerland)
|July 27, 2022
PubMed

Insights

Empiric treatments for pediatric vasovagal syncope showed limited efficacy in reducing recurrence. Further studies are needed to explore individualized therapies for better outcomes in children.

Area of Science:

  • Pediatrics
  • Cardiology
  • Clinical Research

Background:

  • Vasovagal syncope is common in children.
  • Empiric treatment strategies are widely used but their efficacy is not well-established.
  • This study evaluated different empiric treatments for pediatric vasovagal syncope.

Purpose of the Study:

  • To assess the efficacy of four different empiric treatment strategies for vasovagal syncope in children.
  • To compare the recurrence rates of syncope and presyncope among treatment groups.
  • To determine if conventional treatment, oral rehydration salts, metoprolol, or midodrine hydrochloride yield different outcomes.

Main Methods:

  • Retrospective case-control study of 181 children diagnosed with vasovagal syncope.
  • Participants were assigned to four groups: conventional treatment, conventional + oral rehydration salts, conventional + metoprolol, or conventional + midodrine hydrochloride.
  • Kaplan-Meier curves and log-rank tests were used to analyze recurrence rates over a median follow-up of 20 months.

Main Results:

  • No significant difference in the recurrence of syncope or presyncope was observed among the four empiric treatment groups.
  • The log-rank test showed no statistically significant variation in outcomes between the treatment strategies (χ = 1.328, p = 0.723).
  • Eleven out of 181 patients were lost to follow-up.

Conclusions:

  • Current unselected empiric therapies for pediatric vasovagal syncope demonstrate limited effectiveness in preventing recurrence.
  • Individualized treatment approaches tailored to specific patient characteristics may offer better therapeutic results.
  • Further research is warranted to develop and validate personalized treatment protocols for vasovagal syncope in children.

Keywords:
childrenefficacyempiric therapyvasovagal syncope

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