The role of orthostatic training in the treatment of patients with vasovagal syncope

Aim: Despite its good prognosis, vasovagal syncope significantly impairs the quality of life because of the recurrent symptoms. Recently, studies have been published about the fact that treatment of patients with vasovagal syncope with orthostatic training can reduce symptoms. The aim of this study is to investigate the effect of the treatment of orthostatic training in patients with vasovagal syncope.Material and method: Thirty patients (11 men, 19 women, mean age 37.7 ± 15.7) with a diagnosis of vasovagal syncope according to clinical and tilt table test were enrolled in the study. Orthostatic training was given to patients every day for three months. Tilt table test was repeated with the same protocol at the end of third month. After evaluating the tilt test, patients were given the option to leave or to continue orthostatic training. Patients were followed for an average of nine months.Results: There was reduction in the number of syncope and presyncope compared to pre-training (p<0.001). Time to positive tilt test was prolonged at control tilt table test compared to the baseline tilt test (p=0.05). Systolic (p=0.001) and diastolic (p<0.001) blood pressures were found to be significantly higher in positive control tilt test compared to positive basal tilt test. However, there was no significant difference in heart rate (p=0.84). According to the number of orthostatic training group (45 sessions more or less), positive tilt test were significantly decreased (88.2% to 11.8%, p<0.001) in patients who had more than 45 sessions. It showed weak positive relationship between the number of training and age (r =0.392, p=0.032).Conclusion: Orthostatic training can be considered to be a treatment modality that can be recommended for patients with high motivation and complianceKey words: Vasovagal syncope, orthostatic training, tilt table test