Author + information
- Received August 19, 2011
- Revision received November 26, 2011
- Accepted November 29, 2011
- Published online May 1, 2012.
- ↵⁎Reprint requests and correspondence:
Dr. Michele Brignole, Department of Cardiology, Arrhythmologic Centre and Syncope Unit, Ospedali del Tigullio, 16033 Lavagna, Italy
Significant progress has been made in the past 3 decades in our understanding of the various causes of loss of consciousness thanks to the publication of several important studies and guidelines. In particular, the recent European Society of Cardiology guidelines provide a reference standard for optimal quality service delivery. This paper gives the reader brief guidance on how to manage a patient with syncope, with reference to the above guidelines. Despite the progress made, the management of patients with syncope remains largely unsatisfactory because of the presence of a significant gap between knowledge and its application. Two new concepts aimed at filling that gap are currently under evaluation: syncope facilities with specialist backup and interactive decision-making software. Preliminary data have shown that a standardized syncope assessment, especially when coupled with interactive decision-making software, decreases admission rate and unnecessary testing and improves diagnostic yield, thus reducing cost per diagnosis. The long-term effects of such a new health care model on the rate of diagnosis and survival await future studies.
Both authors are the inventors of the software described in this paper (Faint-Algorithm, F2 Solutions Inc., Sandy, Utah); and have financial interest in the start-up company that has exclusive rights to the software product. Dr. Hamdan is a consultant for Medtronic and eCardio; and has received fellowship support from Medtronic, Boston Scientific, and Biotronik.
- Received August 19, 2011.
- Revision received November 26, 2011.
- Accepted November 29, 2011.
- American College of Cardiology Foundation
- Syncope and Its Context
- Classification and Treatment
- Diagnostic Algorithm
- Laboratory Provocative Tests Versus Documentation of Spontaneous Events
- The Magnitude of the Care Gap in the Evaluation of Patients With Syncope
- Syncope Facilities, Algorithms, and Interactive Decision-Making Software