Tilt training prevents fainting

According to a study presented today at the EHRA Congress 2019, a congress of the European Society of Cardiology (ESC), tilt training effectively prevents fainting. The program also improved quality of life, reduced worries and fears about future fainting, and allowed patients to return to work.

"Our study included teachers who fainted in the clbadroom and had to leave work," said Dr. Sergio Laranjo, author of the study, from Santa Marta Hospital in Lisbon. , in Portugal. "None of the conventional treatments had helped, but after an introductory training, they stopped fainting and were able to resume their work."

Fainting affects one person in two during their lifetime and is one of the main conditions of emergency care. For some people with recurring episodes, their lives are limited – they end up in an emergency or are admitted to the hospital, and fear prevents them from working and socializing. Fainting is caused by a drop in blood pressure and / or the number of heartbeats. The most common triggers are the presence of a hot or crowded space or sitting too quickly. Some patients have no warning signs and medications or devices are not helpful.

An inclined training program has been designed to recycle the autonomic nervous system (which controls heart rate and blood pressure) to properly respond to vertical movement.

The response of the autonomic nervous system and the cardiovascular system has improved – for example, the blood pressure has not dropped when the patient has straightened and the cardiac output (volume of blood pumped at each beat) is normalized. But more importantly, on average 5.5 years after the program, 86% of patients had not yet pbaded out. In the rest (14%), the average number of annual fainting episodes (syncope) and presyncopal (fainting) decreased significantly by more than half – from five fainting to fewer than two and more than 11 episodes presyncopal to less than five.

Twenty-five patients completed the "Impact of Syncope on Quality of Life" questionnaire prior to tilt training and six months later. It turns out that tilt training was significantly badociated with less anxiety, fear and frustration badociated with fainting.

"The patients were able to lead a normal and complete life after the tilt training program," said Dr. Laranjo. "Most of the participants were of working age – their average age was 46 – and could return to work."

The study included 102 patients who had fainted at least twice during the previous six months or who had fainted once and who had had three presyncopal episodes during the first six months of life. last year.

The protocol consisted of two parts. In the hospital area, patients lie on a table that can be up to 60 ° C for six sessions and at 70 ° C three times – each time being elevated for 20 to 30 minutes while measuring electrocardiograms and arterial pressure. The nine sessions were spread over three weeks, there was a break of one month and the nine sessions were repeated for three weeks. The home party consisted of sitting in the bed at 60-70 ° for 30 minutes a day, sleeping with extra pillows so that the head was at 10 °, avoiding fast vertical movements, drinking around 2.5 liters of water a day and do aerobics exercises. for 30 minutes a day.

Aerobic exercise has been included to recycle muscles and the cardiovascular system, noted Dr. Laranjo. "Despite their young age, the fear of fainting made these patients very inactive," he said.

Dr. Laranjo said that many patients with syncope pbaded from one doctor to another in specialties without effective treatment. "These results show that tilt training is a safe and effective treatment option for selected patients with recurrent syncopal episodes," he said.

The ESC guidelines recommend that patients be referred to a syncope unit for multidisciplinary badessment, diagnosis, treatment and multidisciplinary follow-up.

More information:
The abstract "Long-term effectiveness of tilt training in the treatment of reflex syncope" will be presented during poster session 2: Syncope and Bradycardia on Monday, March 18 from 8:30 am to 6:00 pm l & # 39; displays).

Provided by
European Society of Cardiology