Syncope secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Sahar Memar Montazerin, M.D.[3]

Overview

Secondary prevention strategies following syncope include ICD implantation in ventricular arrhythmia and avoidance of driving for a specific time based on the guideline.

Secondary Prevention

Secondary prevention strategies following syncope include ICD implantation in ventricular arrhythmia and avoidance of driving for specific time based on the guideline.^[1]

Condition	Time needed for avoidance of driving after syncope
Ortosthasis hypotension	1 month
Vasovagal syncope, no syncope in last year	No restriction
Vasovagal syncope, 1-6 syncope per year	1 month
Vasovagal syncope, >6 syncope per year	No permission until resolving the symptoms
Situational syncope other than cough syncope	1 month
cough syncope, not treated	No permission
cough syncope, treaten with cough suppression	1 month
carotid sinus syncope, not treated	No permission
carotid sinus syncope, treated with permanent pacemaker	1 week
Non reflex sinus bradycardia syncope, not treated	No permission
Non reflex sinus bradycardia syncope,permanent pace maker implantation	1 week
SVT leading syncope, not treated	No permission
SVT leading syncope, arrhythmia suppression with medications	1 month
SVT leading syncope, arrhythmia ablation	1 week
LVEF< 35% , suspected arrhythmic syncope without ICD	No permission
LVEF< 35% , suspected arrhythmic syncope with ICD	3 months
LVEF> 35%, structural heart disease,VT or VF leading syncope, not treated	No permission
LVEF> 35%, structural heart disease,VT or VF leading syncope, treated with ICD implantation and medications	3 months
Syncope due to VT from RVOT, LVOT regions, untreated	No permission
Syncope due to VT from RVOT, LVOT regions , treated with ICD implantation and medications	3 months
Syncope of undetermined etiology	1 month

References

↑ Shen, Win-Kuang; Sheldon, Robert S.; Benditt, David G.; Cohen, Mitchell I.; Forman, Daniel E.; Goldberger, Zachary D.; Grubb, Blair P.; Hamdan, Mohamed H.; Krahn, Andrew D.; Link, Mark S.; Olshansky, Brian; Raj, Satish R.; Sandhu, Roopinder Kaur; Sorajja, Dan; Sun, Benjamin C.; Yancy, Clyde W. (2017). “2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society”. Circulation. 136 (5). doi:10.1161/CIR.0000000000000499. ISSN 0009-7322.

Overview