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Europace 2006 8(12):1017-1021; doi:10.1093/europace/eul134
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

SYNCOPE

The ACCF/AHA Scientific Statement on Syncope: a document in need of thoughtful revision

David G. Benditt {dagger} on behalf of the Ad Hoc Syncope Consortium

Cardiovascular Division, Cardiac Arrhythmia Center, University of Minnesota Medical School, Mail Code 508, 420 Delaware St SE, Minneapolis, MN 55455, USA

Abstract

The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have recently published, in both the Journal of the American College of Cardiology (JACC) and Circulation, a Scientific Statement on the Evaluation of Syncope (‘Statement’). This Scientific Statement was commissioned to provide guidance for clinicians regarding the evaluation of patients who present with ‘syncope’. The Statement was not intended to be a formal set of practice guidelines. However, in the absence of generally accepted practice guidelines in North America, the Statement's potential impact on clinical care may be more far-reaching than expected; it may erroneously be considered to be the authoritative ‘de-facto’ guideline document. This commentary, submitted by a multidisciplinary consortium of more than 60 physicians with expertise in the management of transient loss of consciousness (TLOC), points out that in many respects the ACCF/AHA Syncope Statement fails to address long-standing clinical errors associated with the evaluation of episodes of apparent TLOC, including syncope. If not appropriately revised, the current Statement may lead to both inadequate patient care as well as a potentially damaging legal environment for physicians undertaking evaluation of patients who present with transient loss of consciousness.

Key Words: Syncope, Practice guidelines, Diagnosis, Evaluation, Management

Corresponding author. Tel: +1 612 625 4401; fax: +1 612 624 4937. E-mail address: bendi001{at}umn.edu


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