Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2016, 25(2):99-106

Isometric counterpressure manoeuvres in prevention of reflex vasovagal syncope

Müller E, Mitro P
Klinika kardiológie UPJŠ LF a VÚSCH a.s., Košice, Slovenská republika

Vasovagal syncope (VVS) is the most common type of syncope. Patients with frequent recu­ rrences of VVS have significantly reduced quality of life. Pharmacological treatment is limited by lack of efficacy, and incidence of adverse events. Cardiac pacing is reserved for the strictly-selected older patients with cardioinhibitory response and absence of prodromal symptoms based on evidence-based medicine. Isometric counterpressure manoeuvres (ICM) are indicated as first-line treatment in patients with VVS and prodromes. They improve perfusion of the brain during impending syncope due to increase of blood pre­ ssure and cardiac output. They are especially effective in younger patients with recognizable prodromal symptoms. Leg crossing with muscle tensing significantly increases systolic and diastolic blood pressure. ICMs are more efficient than conventional non-pharmacological treatment, they significantly reduce the number of recurrences of VVS in comparison to conventional non-pharmacological treatment. The impact of ICMs on the quality of life is less documented and should be more studied.

Keywords: blood pressure; cardiac output; isometric counter-pressure manoeuvres; treatment; vas­ ovagal syncope

Published: February 1, 2016  Show citation

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Müller E, Mitro P. Isometric counterpressure manoeuvres in prevention of reflex vasovagal syncope. Cardiology Letters. 2016;25(2):99-106.
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