Study of atrioventricular interphase changes in patients with vasovagal syncope during head-up tilt table test
Objective To study the changes of atrioventricular interval in different types of vasovagal syncope in head up tilt table test.Methods A total of 78 patients with syncope and syncope aura with positive head up tilt test(34 males and 44 females,with an average age of 37.87±19.10 years)from January 2018 to December 2020 in the outpatient and inpatient departments of Jiangmen Central Hospital were collected,and the atrioventricular interval data of patients in horizontal position,vertical tilt position,before syncope and after returning to horizontal position during the head up tilt test were analyzed.Results The atrioventricular interval of patients with cardiac inhibitory vasovagal syncope was(150.50±10.60)ms,which was longer than(132.50±7.33)ms in upright tilt position(P＜0.05);The PR interval before syncope in patients with mixed vasovagal syncope was(118.29±7.78)ms,which was shorter than(133.14±5.38)ms in oblique position(P＜0.05);The PR interval before syncope in patients with vasoinhibitory vasovagal syncope was(122.10±6.25)ms,which was shorter than that in tilt position(139.93± 4.32)ms(P＜0.05).The results of age analysis showed that the PR interval of all types of syncope in the child group was shorter than that in the upright tilt position,but there was no significant difference between the two in the vascular inhibitory vasovagal syncope.The PR interval of vasovagal syncope type 2 and vasovagal syncope type 3 syncope in the adult group was shorter than that in the upright tilt position,while that in the cardiac inhibitory type was longer.The comparative analysis of different genders showed that the changes of PR interval of men and women in various postures during various types of syncope were similar to the results of the overall analysis.Conclusions During syncope or syncope aura,cardiac inhibitory vasovagal syncope is accompanied by prolonged atrioventricular interval,slow sinus beat or atrioventricular block above height,and even cardiac arrest,while vascular inhibitory and mixed vasovagal syncope have shortened PR interval,suggesting different production mechanisms of different types of vasovagal syncope,which can be used as an early warning of syncope in the future.The mechanism of autonomic nervous system function in children group is different from that in adults,but it needs to increase the sample size for analysis.
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