Investigation of New Therapy with Orthostatic Self-Training and Mechanisms for Neurocardiogenic Syncope

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The purpose of the present study was to investigate the efficacy of home orthostatic self-training program for the prevention of tilt-induced neurocardiogenic syncope. A total of 46 neurocardiogenic syncopal patients, who had experienced spontaneous syncope and were diagnosed by head-up tilt testing (80 degrees for 30 min), were included in the present study. All patients were treated with home orthostatic self-training alone for 30 minutes without any drug therapy and reevaluated within 4 weeks with the same protocol of initial tilt testing. Reevaluated head-up tilt testing could not induce the syncope after the home orthostatic self-training. Heart rate variability after the training showed significant decrease of L/H ratio at the early stage of upright position compared to that before training. All patients were successfully treated with home orthostatic self-training alone without any symptoms such as syncope or presyncope during the long-term follow-up of mean 11 months. We concluded that home orthostatic self-training is a very effective, safe and useful therapeutic option for the prevention of tilt-induced neurocardiogenic syncope.