In this section
@article{Virag:2018:10.1016/j.hrthm.2018.04.032,
author = {Virag, N and Erickson, M and Taraborrelli, P and Vetter, R and Lim, PB and Sutton, R},
doi = {10.1016/j.hrthm.2018.04.032},
journal = {Heart Rhythm},
pages = {1404--1410},
title = {Predicting vasovagal syncope from heart rate and blood pressure: A prospective study in 140 subjects},
url = {http://dx.doi.org/10.1016/j.hrthm.2018.04.032},
volume = {15},
year = {2018}
}
TY - JOUR
AB - BACKGROUND: We developed a vasovagal syncope (VVS) prediction algorithm for use during head-up tilt with simultaneous analysis of heart rate (HR) and systolic blood pressure (SBP). We previously tested this algorithm retrospectively in 1155 subjects, showing sensitivity 95%, specificity 93% and median prediction time of 59s. OBJECTIVE: This study was prospective, single center, on 140 subjects to evaluate this VVS prediction algorithm and assess if retrospective results were reproduced and clinically relevant. Primary endpoint was VVS prediction: sensitivity and specificity >80%. METHODS: In subjects, referred for 60° head-up tilt (Italian protocol), non-invasive HR and SBP were supplied to the VVS prediction algorithm: simultaneous analysis of RR intervals, SBP trends and their variability represented by low-frequency power generated cumulative risk which was compared with a predetermined VVS risk threshold. When cumulative risk exceeded threshold, an alert was generated. Prediction time was duration between first alert and syncope. RESULTS: Of 140 subjects enrolled, data was usable for 134. Of 83 tilt+ve (61.9%), 81 VVS events were correctly predicted and of 51 tilt-ve subjects (38.1%), 45 were correctly identified as negative by the algorithm. Resulting algorithm performance was sensitivity 97.6%, specificity 88.2%, meeting primary endpoint. Mean VVS prediction time was 2min 26s±3min16s with median 1min 25s. Using only HR and HR variability (without SBP) the mean prediction time reduced to 1min34s±1min45s with median 1min13s. CONCLUSION: The VVS prediction algorithm, is clinically-relevant tool and could offer applications including providing a patient alarm, shortening tilt-test time, or triggering pacing intervention in implantable devices.
AU - Virag,N
AU - Erickson,M
AU - Taraborrelli,P
AU - Vetter,R
AU - Lim,PB
AU - Sutton,R
DO - 10.1016/j.hrthm.2018.04.032
EP - 1410
PY - 2018///
SN - 1547-5271
SP - 1404
TI - Predicting vasovagal syncope from heart rate and blood pressure: A prospective study in 140 subjects
T2 - Heart Rhythm
UR - http://dx.doi.org/10.1016/j.hrthm.2018.04.032
UR - https://www.ncbi.nlm.nih.gov/pubmed/29715516
UR - http://hdl.handle.net/10044/1/59747
VL - 15
ER -