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By P. M. Spooner (auth.), Antonio Raviele MD (eds.)

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Extra info for Cardiac Arrhythmias 2001: Proceedings of the 7th International Workshop on Cardiac Arrhythmias (Venice, 7–10 October 2001)

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Furthermore, it is well known that, when patients are reassured of the substantially benign nature of their problem, they have significantly fewer syncopal recurrences [19]. Finally, it should be pointed out that the only drug shown to be efficacious in preventing vasovagal syncope in placebo-controlled studies [20] is paroxetine, an inhibitor of serotonin re-uptake commonly used as an antidepressant. To our knowledge, the present study is the first to analyze psychological profile and QOL systematically in patients with documented vasovagal syncope and no concomitant associated diseases, and to compare these data with those obtained in a control group of healthy sex- and age-matched subjects without syncope.

Am Heart J 122:1644-1651 31. Brignole M, Menozzi C, Del Rosso A et al (2000) New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Europace 2:66-76 32. Kapoor WN (1991) Diagnostic evaluation of syncope. Am J Med 90:91-106 33. Lipsitz LA, Wei JY, Rowe JW (1985) Syncope in an elderly, institutionalised population: prevalence, incidence and associated risk. Qu J Med 55:45-54 13.

There was no difference in the plasma norepinephrine response to these three meals. These data lend support to a vasodepressor action of insulin in the pathogenesis of PPH. Diagnostic Evaluation Any patient with a fall, syncope, or symptoms of dizziness or lightedheadedness within 2 h of eating a meal should be evaluated for PPH. Although it is advisable to measure blood pressure in the sitting position before, and at 15 min intervals after a standardized 400 kcal high-carbohydrate meal (70-80% of calories from carbohydrate) [ 1], this is not always practical in the clinical setting.

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