The criterion standard for the diagnosis of arrhythmic syncope a correlation between symptoms and an ECG recording. The presence of asymptomatic significant arrhythmias—defined as prolonged asystole (≥ 3 sec), rapid supraventricular tachycardia (> 160 beats/min for > 32 beats), or ventricular tachycardia—has been considered by several authors to be a diagnostic finding.
Angiography alone is not diagnostic of the cause of syncope. Therefore, cardiac catheterization should be done in suspected myocardial ischemia or infarction with the same indications as for patients without syncope.
Sufficient evidence from multiple trials indicates that beta-blockers are not appropriate in reducing syncopal recurrences. Desirable and undesirable effects are closely balanced.
The efficacy of therapy aimed at preventing syncope recurrence is largely determined by the mechanism of syncope rather than its etiology. Bradycardia is a frequent mechanism of syncope. Cardiac pacing is the most powerful therapy for bradycardia, but its efficacy is less if hypotension coexists.
For more on these guidelines, read here.
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Cite this: Yasmine S. Ali. Fast Five Quiz: New Cardiology Guidelines - Medscape - Oct 25, 2018.