Assessment of vasovagal origin of syncope based on history features]

Study aim was to elaborate questionnaire for diagnostics of vasovagal syncope (VVS) based on data of anamnesis. We examined 182 patients (mean age 37.1+/-14.3 years, 78 men, 104 women). Initial examination included anamnesis, physical examination, electrocardiography at rest, measurement of blood pressure in orthostasis. Each patient was asked 82 questions describing duration of symptoms, characteristics of episodes of loss of consciousness, symptoms of prodromal period before loss on consciousness and in the period of recovery. As a standard method of VVS diagnostics of we used tilt test (TT) according to Westminster or Italian protocols. Using methods of statistical analysis we created questionnaire for diagnostics of VVS. Tilt-positive group comprised 108 patients (age 35.9+/-14.6 years, 45% men), tilt-negative group comprised 74 patients (age 36.1+/-14.3 years, 39% men). Of 82 testing questions 8 had probability ratio (PR) >1 and were significant predictors (p<0.05) of positive TT. Seven questions had <1 and were significant predictors (p<0.05) of negative TT. These questions were included into logistical regression analysis. The final variant of the questionnaire comprises 15 vasovagal origin questions. Total score necessary for diagnosis of VVS is >= 1. Sensitivity of questionnaire for prediction of positive result of TT was 95%, specificity - 57%. This allows to using it as a screening test for selection of further method of investigation in patients with episodes of loss of consciousness.