Implementation of Supervised Physical Training to Reduce Vasovagal Syncope Recurrence: A Randomized Controlled Trial Publisher Pubmed



Aghajani F¹ ; Tavolinejad H^{1, 2} ; Sadeghian S¹ ; Bozorgi A¹ ; Jalali A¹ ; Vasheghanifarahani A¹ ; Yadangi S¹ ; Niazi S¹ ; Poopak A¹ ; Tajdini M¹ Show Affiliations
Source: Journal of Cardiovascular Electrophysiology Published:2022

Abstract

Introduction: Physical techniques used for the prevention of vasovagal syncope have limited evidence for efficacy. We aimed to evaluate multimodal supervised physical training as a treatment approach. Methods: In this 1:1 randomized trial, patients with ≥2 episodes of clinically diagnosed vasovagal syncope were included. On top of standard care, the intervention arm performed supervised tilt training and aerobic exercise in six sessions at a cardiac rehabilitation center (three sessions during the first month, and then at 3-month intervals), plus home tilt training. The control arm received standard care with a similar protocol of home tilt training. The primary outcome was time to first syncopal recurrence during 1 year of follow-up. Results: Fifty participants were randomized (mean age: 34.5 ± 14.8 years; 64% female). The rate of syncopal recurrence was 28% and 64% within the intervention and control arms, respectively, with significantly higher syncope-free survival at 1 year in the intervention arm (Log-rank p =.003). The frequency of recurrent syncopal events was significantly lower with physical training (p =.017). Participants in the intervention arm reported significantly higher adherence to the home tilt training program (80% vs. 52%; p =.037). Conclusion: Among patients with recurrent vasovagal syncope, a supervised program of tilt training and aerobic exercise reduced syncopal recurrence. Future trials are warranted to further investigate multimodal supervised physical techniques as a therapeutic approach in treating vasovagal syncope. © 2022 Wiley Periodicals LLC.