What is the Optimal Increase in Resting Heart Rate with Low Dose Isoproterenol Infusion for Tilt-Induced Vasovagal Response?

Home Orthostatic Self-Training in Neurocardiogenic Syncope

We assessed the efficacy of daily sessions of home orthostatic self-training (30 minutes per session standing against the wall without moving) in the prevention of neurocardiogenic syncope in 37 patients. Of these, 10 patients were instructed to perform two sessions per day, 14 were instructed to perform a single session per day, and the remaining 13 were instructed to perform one session every other day. The patients who performed one to two sessions of training per day continued to do so over a 6-month follow-up period, during that time none of them experienced spontaneous syncope. Only 5 of 13 patients who were instructed to train once every two days were able to continue doing so over the 6-month follow-up period; however, no spontaneous syncope was observed in these five patients. The remaining 8 of 13 patients could not continue their home training, and syncope or presyncope recurred in three of them during follow-up. We conclude that one session per day of home orthostatic self-training should be prescribed for the prevention of neurocardiogenic syncope.