Objective-To evaluate the efficacy of head up tilt guided treatment with metoprolol and clonidine in preventing the recurrence of syncope in patients with malignant vasovagal syncope. Patients-20 patients (9 men and 11 women, mean age 33 (SD 17), range 14 to 62 years) with severe symptoms. Design-Randomised double blind cross-over trial; efficacy was assessed by head up tilt testing. Results-Metoprolol was more effective than clonidine in abolishing syncope (19/20 v 1/20, P < 0.001) but clonidine showed some beneficial effects on time to syncope and severity of hypotension in 12 patients. During an average follow up of 15 (3) months there was a significant reduction in the recurrence of symptoms compared with the previous year in patients who had tilt up guided treatment (18 metoprolol, 1 clonidine). Conclusions-Treatment guided by head up tilting is a reliable method of treating patients with malignant vasovagal syndrome. Metoprolol was an effective long term treatment for preventing syncope. High doses were more effective and a careful dose titration period helped to minimise withdrawal symptoms and side effects.

Malignant vasovagal syncope: A randomised trial of metoprolol and clonidine / Biffi, M; Boriani, Giuseppe; Sabbatani, P; Bronzetti, G; Frabetti, L; Zannoli, R; Branzi, A; Magnani, B.. - In: HEART. - ISSN 1355-6037. - 77:3(1997), pp. 268-272. [10.1136/hrt.77.3.268]

Malignant vasovagal syncope: A randomised trial of metoprolol and clonidine

BORIANI, Giuseppe;
1997

Abstract

Objective-To evaluate the efficacy of head up tilt guided treatment with metoprolol and clonidine in preventing the recurrence of syncope in patients with malignant vasovagal syncope. Patients-20 patients (9 men and 11 women, mean age 33 (SD 17), range 14 to 62 years) with severe symptoms. Design-Randomised double blind cross-over trial; efficacy was assessed by head up tilt testing. Results-Metoprolol was more effective than clonidine in abolishing syncope (19/20 v 1/20, P < 0.001) but clonidine showed some beneficial effects on time to syncope and severity of hypotension in 12 patients. During an average follow up of 15 (3) months there was a significant reduction in the recurrence of symptoms compared with the previous year in patients who had tilt up guided treatment (18 metoprolol, 1 clonidine). Conclusions-Treatment guided by head up tilting is a reliable method of treating patients with malignant vasovagal syndrome. Metoprolol was an effective long term treatment for preventing syncope. High doses were more effective and a careful dose titration period helped to minimise withdrawal symptoms and side effects.
1997
77
3
268
272
Malignant vasovagal syncope: A randomised trial of metoprolol and clonidine / Biffi, M; Boriani, Giuseppe; Sabbatani, P; Bronzetti, G; Frabetti, L; Zannoli, R; Branzi, A; Magnani, B.. - In: HEART. - ISSN 1355-6037. - 77:3(1997), pp. 268-272. [10.1136/hrt.77.3.268]
Biffi, M; Boriani, Giuseppe; Sabbatani, P; Bronzetti, G; Frabetti, L; Zannoli, R; Branzi, A; Magnani, B.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1080507
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