The Role of Acute Physical Maneuver in Preventing Vasovagal Syncope: A Randomized Clinical Trial

Abstract

Background: Recurrent vasovagal syncope (VVS) can be severely disabling disorders that may lead to an important deterioration of quality of life because of the severity and recurrence of episodes. Objectives: The current study aimed to investigate the eects of repetitive acute physical maneuver on preventing syncope in patients with recurrent VVS. Patients and Methods: Ninety-six out of one hundred patients (mean age 42.12 15.11 years, 72 males) with VVS episodes and positive tilt tests were enrolled. The patients were randomized to three groups: 1) hand grip maneuver, 2) squatting maneuver, and 3) control group. The patients were followed up for spontaneous syncope for two years. Results: After two years of follow-up, there were significant dierences between the physical maneuvers and control group regarding the baseline clinical characteristics. The rate of recovery in hand grip maneuver was 65% but in squatting maneuver it was 75% in comparison with the control group that was 43% (P = 0.029). Conclusions: Both hand grip and squatting maneuvers can prevent recurrent syncope in young patients with vasovagal syncope and prodromal symptoms.