Dr. Jacek Gajek,
This Symposium highlighted filling the gaps in scientific and clinical evidence between daily life practice and the ESC Guidelines on syncope. Prof. Angel Moya from Barcelona, Spain emphasized the importance of a standardized, step-by-step approach, following the Guidelines recommendations. Common sense and medical judgement should be applied, especially in cases of borderline diagnostic or therapeutic indications. Strict adherence to the recommended pathways provides the best final results. Prof. Rose Anne Kenny from Dublin, Ireland, based her lecture on the discussion of the Position Paper on syncope of the Canadian Cardiovascular Society published in 2011. The most important message coming from this statement and the literature indicate the need to establish structured syncope units/clinics. Such facilities can definitely save beds, especially in Intensive Cardiac Care departments, provide excellent diagnostic results and save money. In the Emergency Department, however, the well-known risk factors for bad outcome in patients with syncope are the same as those that indicate the other serious health problems. Prof. Michele Brignole from Lavagna, Italy highlighted the importance of prolonged ECG monitoring in patients with syncope, without life-threatening conditions indicating the need to obtain the diagnosis immediately. The true nature of the cause of syncope can be assessed with time and enable proper and effective treatment. Prof. Richard Sutton then discussed the results from various pacemaker trials in patients with syncope focusing in particular on the results of ISSUE-3 study. The take-home message was that pacing in patients with syncope should be considered only in selected individuals with bradycardia/asystole background mechanism established in daily life conditions. The session was an outstanding educational event held by top-scientists in the field of syncope management. The authors again taught us to understand the problem of diagnosis and management of loss of consciousness.
Syncope management: filling gaps between guidelines and practice
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