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Europace Advance Access published online on June 4, 2007
Europace, doi:10.1093/europace/eum104
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Daily, weekly, monthly, and seasonal patterns in the occurrence of vasovagal syncope in an older population

Nynke van Dijk1,*, Mardi C. Boer2, Tiziana De Santo3, Nicoletta Grovale3, Arnaud J.J. Aerts4, Lucas Boersma5 and Wouter Wieling2

1 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, PO Box 22700, 1100 DE Amsterdam, The Netherlands; 2 Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands; 3 Medtronic Italia, S.p.A., Italy; 4 Department of Cardiology, Atrium Medical Centre, Heerlen, The Netherlands; 5 Cardiology Department, St Antonius Hospital, Heat Lung Centre, Utrecht, The Netherlands

Aims The aim of this study was to assess the frequency of vasovagal episodes over the day, week, month, and seasons.

Methods and results This study was part of the multi-centre International Study on Syncope of Uncertain Etiology-2 (ISSUE-2), which included patients, aged 30 years or older, with severe neurally mediated syncope between June 2002 and July 2004. The Implantable Loop Recorder (ILR) was used to document the syncope-related ECG periods. For this study patients with recorded syncopal episodes after ILR-implantation was selected. At least one episode was documented in 106 patients. A higher number of episodes were documented during the morning than during other periods of the day (P < 0.01). There was no difference between various days of the week, episodes per month, or between seasons. There was no difference between age and gender groups, although elderly patients seemed to be responsible for the peak in the morning.

Conclusion A circadian pattern in the frequency of vasovagal episodes exists, with a peak in the morning. This is in accordance with reports of diurnal variations in blood pressure and heart rate. No difference was observed in syncope distribution between days of the week, months, or seasons.

Key Words: Syncope, Vasovagal, Implantable loop recorder, Daily variation, Weekly variation, Seasonal variation

* Corresponding author. Tel: +31 20 56668975; fax: +31 20 6912683. E-mail address: n.vandijk{at}amc.uva.nl

Manuscript submitted 23 February 2007. Accepted after revision 26 April 2007.


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