Stop Vasodepressor Drugs in Reflex Syncope
Stop Vasodepressor Drugs in Reflex Syncope
Investigate clinical effects (reduction of number of syncope and associate symptoms) of
 suspension of vasoactive drugs in patients affected by vasodepressor reflex syncope.
Several drugs which are commonly used in clinical practice, such as antihypertensive,
 antiarrhythmic and psychiatric drugs, are associated with orthostatic hypotension and
 syncope. This phenomenon is much more evident in the elderly and with multiple therapies. The
 present study was aimed to investigate, in patients affected by reflex syncope, the clinical
 effects (reduction in syncope recurrence and associated symptoms) and the laboratory tests
 (negativization of carotid sinus massage and tilt table test) when such drugs are
 discontinued or reduced
Inclusion Criteria:

 Patients assuming chronic (>1 year) vasoactive therapy affected by reflex recurrent (>2
 episodes) syncopes who have a positive dominant vasodepressor or mixed response to tilt
 table test and/or carotid sinus massage

 Exclusion Criteria:

 1. Orthostatic hypotension defined as fall in systolic blood pressure >20 mmHg during the
 first 3 minutes of active standing

 2. Competing diagnosis of syncope different from hypotensive reflex syncope

 3. Reflex syncope with negative response to carotid sinus massage and tilt table test

 4. Cardioinhibitory reflex syncope which requires permanent cardiac pacing

 5. Severe hypertension which requires treatment (>150/95)

 6. Structured heart disease which requires hypotensive therapy in order to prevent acute
 heart failure

 7. Cardiac hypotensive therapy in order to prevent recurrences

 8. Previous stroke or transient ischemic attacks