Características clínicas y score de riesgo de sincope cardiogénico de los pacientes llevados a estudio electrofisiológico en la Fundación Cardioinfantil 2013-2017
Thesis
Background: Syncope due to arrhythmias, debuts with higher mortality than syncope of another cause, therefore, in view of the need to discern between them, many clinical risk factors and syncope risk scores have been identified, therefore, patient with high scores, encourage the practice of continuous rhythm monitoring and even invasive electrophysiological study(EPS) in order to rule out arrhythmic cause. The aim of this study is to recognize the clinical characteristics most related to syncope due to arrhythmias and to describe the role of four risk scores, in terms of the initial approach in a group of patients taken to electrophysiological study for suspected arrhythmogenicity. Methods: This is a descriptive and retrospective study, where we described the clinical characteristics and four risk scales scores of cardiogenic syncope, Osservatorio Epidemiologico sulla Sincope nell Lazio(OESIL), Evaluation of Guidelines of syncope (EGSYS), San Francisco and Canadian syncope risk score(CSRS), from patients with and without final diagnosis of syncope for arrhythmias, taken to electrophysiological study in the years 2013 to 2017 in a cardiovascular hospital in Latin America, using means of frequencies, percentages and medium ranges, and a bivariate analysis was carried out to explore its distribution in patients with and without diagnostic confirmation. Results: A total of 26 patients were included. The median age was 63 years, the majority were men (57. 7%), in 5 cases (19. 2%), abnormal EPS was found, 40% (2 cases) by ventricular tachycardia, 40 % (2 cases) by prolonged Hiss-Ventricle interval and 20% (1 case) due to sinus dysfunction. Cardiogenic syncope by arrhythmias diagnosed through EPS was more frequent in men who presented bradycardia or syncope during exercise (p < 0. 05). In correlation with other scales, only EGSYS had a significantly higher score in patients with abnormal EPS, compared to patients with normal EPS (100% vs. 47. 6%) with p = 0. 033. Conclusion: Syncope due to arrhythmias is more frequently associated with men with bradycardia, the presence of atrioventricular block, its development during physical exertion and a high score on the EGSYS score.
