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ELectrophysiological mechanisms underlying the Inhibitory CArdiac syncope without asystolic significant pause: Therapeutic and prognostic implications. The ELICA randomized trial.

ABSTRACT: The aim of this study was to investigate syncope recurrence in patients with a 2A cardioinhibitory response to the head up tilt testing (HUT).In this study, we enrolled 72 consecutive patients affected by syncope with cardioinhibitory response without asystolic significant pause to HUT (2A type). In these patients, we randomly performed electrophysiological study (ES). In case of sino-atrial node, atrio-ventricular node dysfunction, and sustained arrhythmias induction, the ES resulted positive. ES was positive in 9 patients (group A), then treated by catheter ablation, and/or by devices implants. Otherwise, ES resulted negative (group B), and these patients did not receive an interventional treatment. However, after ES, we evaluated syncope recurrence during 360 days follow-up.There was a lower statistical significant syncope recurrence at follow-up, comparing group A to group B of patients [n of events 9 (40.9%) vs 8 (57.1%), P?

SUBMITTER: Sardu C

PROVIDER: S-EPMC6081146 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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ELectrophysiological mechanisms underlying the Inhibitory CArdiac syncope without asystolic significant pause: Therapeutic and prognostic implications. The ELICA randomized trial.

Sardu Celestino C Marfella Raffaele R Testa Gianluca G Santamaria Matteo M Sacra Cosimo C Ranauro Alfredo A Paolisso Giuseppe G Rizzo Maria Rosaria MR Barbieri Michelangela M

Medicine 20180801 31

<h4>Background</h4>The aim of this study was to investigate syncope recurrence in patients with a 2A cardioinhibitory response to the head up tilt testing (HUT).<h4>Methods</h4>In this study, we enrolled 72 consecutive patients affected by syncope with cardioinhibitory response without asystolic significant pause to HUT (2A type). In these patients, we randomly performed electrophysiological study (ES). In case of sino-atrial node, atrio-ventricular node dysfunction, and sustained arrhythmias in ...[more]

PMID: 30075596

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Project description:BackgroundPrevious studies reported that old adults, relative to young adults, showed improvement of emotional stability and increased experiences of positive affects.MethodsIn order to better understand the neural underpinnings behind the aging-related enhancement of positive affects, it is necessary to investigate whether old and young adults differ in the threshold of eliciting positive or negative emotional reactions. However, no studies have examined emotional reaction differences between old and young adults by manipulating the intensity of emotional stimuli to date. To clarify this issue, the present study examined the impact of aging on the brain's susceptibility to affective pictures of varying emotional intensities. We recorded event-related potentials (ERP) for highly negative (HN), mildly negative (MN) and neutral pictures in the negative experimental block; and for highly positive (HP), mildly positive (MP) and neutral pictures in the positive experimental block, when young and old adults were required to count the number of pictures, irrespective of the emotionality of the pictures.ResultsEvent-related potentials results showed that LPP (late positive potentials) amplitudes were larger for HN and MN stimuli compared to neutral stimuli in young adults, but not in old adults. By contrast, old adults displayed larger LPP amplitudes for HP and MP relative to neutral stimuli, while these effects were absent for young adults. In addition, old adults reported more frequent perception of positive stimuli and less frequent perception of negative stimuli than young adults. The post-experiment stimulus assessment showed more positive ratings of Neutral and MP stimuli, and reduced arousal ratings of HN stimuli in old compared to young adults.ConclusionThese results suggest that old adults are more resistant to the impact of negative stimuli, while they are equipped with enhanced attentional bias for positive stimuli. The implications of these results to the aging-related enhancement of positive affects were discussed.

Dataset Information

ELectrophysiological mechanisms underlying the Inhibitory CArdiac syncope without asystolic significant pause: Therapeutic and prognostic implications. The ELICA randomized trial.

Publications

ELectrophysiological mechanisms underlying the Inhibitory CArdiac syncope without asystolic significant pause: Therapeutic and prognostic implications. The ELICA randomized trial.

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