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Unexplained Syncope: The Importance of the Electrophysiology Study

First Department of Cardiology, National and Kapodistrian University, “Hippokration” Hospital, 11527 Athens, Greece
Department of Cardiology, 424 General Military Hospital, 54124 Thessaloniki, Greece
Athens Heart Center, Athens Medical Center, 11526 Athens, Greece
State Department of Cardiology, “Hippokration” Hospital, 11528 Athens, Greece
Konstantinos A. Gatzoulis, 181 Dorieon str., P.O. Box 175, 19009 Athens, Greece
Author to whom correspondence should be addressed.
Academic Editor: Gaetano Santulli
Hearts 2021, 2(4), 495-504;
Received: 14 September 2021 / Revised: 15 October 2021 / Accepted: 20 October 2021 / Published: 25 October 2021
Syncope of cardiac origin may be associated with an increased risk of sudden cardiac death if not treated in a timely and appropriate manner. The diagnostic approach of syncope imposes a significant economic burden on society. The investigation and elucidation of the pathogenetic mechanism of syncope are of great clinical importance, as both prognosis and appropriate therapeutic approaches depend on these factors. The responsible mechanism of presyncope or syncope can only be revealed through the patient history, baseline clinical examination and electrocardiogram. The percentage of patients who are diagnosed with these tests alone exceeds 50%. In patients with a history of organic or acquired heart disease or/and the presence of abnormal findings on the electrocardiogram, a further diagnostic electrophysiology inclusive approach should be followed to exclude life threatening arrhythmiological mechanism. However, if the patient does not suffer from underlying heart disease and does not show abnormal electrocardiographic findings in the electrocardiogram, then the probability in the electrophysiology study to find a responsible cause is small but not absent. The role of a two-step electrophysiology study inclusive risk stratification approach for the effective management of the former is thoroughly discussed in this review. View Full-Text
Keywords: syncope; presyncope; pacemaker; electrophysiology study; sinus node dysfunction; atrioventricular node disease syncope; presyncope; pacemaker; electrophysiology study; sinus node dysfunction; atrioventricular node disease
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MDPI and ACS Style

Doundoulakis, I.; Soulaidopoulos, S.; Arsenos, P.; Dilaveris, P.; Tsiachris, D.; Antoniou, C.-K.; Sideris, S.; Kordalis, A.; Laina, A.; Kallinikidis, S.; Xydis, P.; Archontakis, S.; Tsioufis, K.; Gatzoulis, K.A. Unexplained Syncope: The Importance of the Electrophysiology Study. Hearts 2021, 2, 495-504.

AMA Style

Doundoulakis I, Soulaidopoulos S, Arsenos P, Dilaveris P, Tsiachris D, Antoniou C-K, Sideris S, Kordalis A, Laina A, Kallinikidis S, Xydis P, Archontakis S, Tsioufis K, Gatzoulis KA. Unexplained Syncope: The Importance of the Electrophysiology Study. Hearts. 2021; 2(4):495-504.

Chicago/Turabian Style

Doundoulakis, Ioannis, Stergios Soulaidopoulos, Petros Arsenos, Polychronis Dilaveris, Dimitris Tsiachris, Christos-Konstantinos Antoniou, Skevos Sideris, Athanasios Kordalis, Ageliki Laina, Sotirios Kallinikidis, Panagiotis Xydis, Stefanos Archontakis, Konstantinos Tsioufis, and Konstantinos A. Gatzoulis. 2021. "Unexplained Syncope: The Importance of the Electrophysiology Study" Hearts 2, no. 4: 495-504.

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