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KMID : 1130620210170010046
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Journal of Clinical Neurology
2021 Volume.17 No. 1 p.46 ~ p.51
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Fludrocortisone in Pediatric Vasovagal Syncope: A Retrospective, Single-Center Observational Study
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Yi Seo-Yeon
Kong Young-Hwa
Kim Sun-Jun
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Abstract
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Background and Purpose: The purpose of this study was to determine the effect of fludrocortisone in patients with pediatric vasovagal syncope (VVS).
Methods: This retrospective observational single-tertiary-center study based on chart reviews included 74 patients who were newly diagnosed with VVS in the head-up tilt-table test (HUTT). Some of the patients had been treated with fludrocortisone. All patients were assessed using a brain and cardiac workup before treatment to rule out the syncope being due to other causes, which resulted in seven of them being excluded: two for epilepsy and five for brain pathologies. The remaining 67 patients were analyzed. The effect of fludrocortisone was evaluated based on the results of a follow-up HUTT, with a response to the treatment considered to be present if there was a negative change at the follow-up HUTT. Univariate logistic regression were used for statistical analyses, with the criterion for significance being p<0.05.
Results: There were no significant differences in the characteristic of the patients between the no-medication (n=39) and fludrocortisone (n=28) groups, including age, sex, and duration of treatment. The recurrence rate of syncopal or presyncopal events was significantly lower in the fludrocortisone group (39.3%, 11 of 28) than in the no-medication group (64.1%, 25 of 39) (p=0.044), as was the rate of negative change at the follow-up HUTT: 57.1% (16 of 28) and 28.2% (11 of 39), respectively (p=0.017).
Conclusions: Our findings suggest that fludrocortisone is more effective than no medication in pediatric patients with VVS.
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KEYWORD
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children, vasovagal syncope, fludrocortisone, head-up tilt-table test
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