Implementation of supervised physical training to reduce vasovagal syncope recurrence: A randomized controlled trial

Introduction Physical techniques used for the prevention of vasovagal syncope have limited evidence for efficacy. We aimed to evaluate multimodal supervised physical training as a treatment approach. Methods In this 1:1 randomized trial, patients with ≥2 episodes of clinically diagnosed vasovagal sy...

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Published in:Journal of cardiovascular electrophysiology 2022-08, Vol.33 (8), p.1863-1870
Main Authors: Aghajani, Faezeh, Tavolinejad, Hamed, Sadeghian, Saeed, Bozorgi, Ali, Jalali, Arash, Vasheghani‐Farahani, Ali, Yadangi, Somayeh, Niazi, Sepideh, Poopak, Amirhossein, Tajdini, Masih
Format: Article
Language:English
Subjects:
Aerobics
Cardiovascular disease
Clinical trials
Exercise
Fainting
Patients
physical education and training
Physical fitness
Physical training
Rehabilitation
rehabilitation center
Syncope
Vasovagal syncope
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Summary:Introduction Physical techniques used for the prevention of vasovagal syncope have limited evidence for efficacy. We aimed to evaluate multimodal supervised physical training as a treatment approach. Methods In this 1:1 randomized trial, patients with ≥2 episodes of clinically diagnosed vasovagal syncope were included. On top of standard care, the intervention arm performed supervised tilt training and aerobic exercise in six sessions at a cardiac rehabilitation center (three sessions during the first month, and then at 3‐month intervals), plus home tilt training. The control arm received standard care with a similar protocol of home tilt training. The primary outcome was time to first syncopal recurrence during 1 year of follow‐up. Results Fifty participants were randomized (mean age: 34.5 ± 14.8 years; 64% female). The rate of syncopal recurrence was 28% and 64% within the intervention and control arms, respectively, with significantly higher syncope‐free survival at 1 year in the intervention arm (Log‐rank p = .003). The frequency of recurrent syncopal events was significantly lower with physical training (p = .017). Participants in the intervention arm reported significantly higher adherence to the home tilt training program (80% vs. 52%; p = .037). Conclusion Among patients with recurrent vasovagal syncope, a supervised program of tilt training and aerobic exercise reduced syncopal recurrence. Future trials are warranted to further investigate multimodal supervised physical techniques as a therapeutic approach in treating vasovagal syncope.
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.15578