{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:04:47Z","timestamp":1785135887599,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gen and Family Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Swallow syncope is a rare reflex syncope, typically treated with pacemaker implantation. Pharmacological alternatives may be considered when pacemaker implantation is not feasible or not concordant with goals of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report a nonagenarian woman with dementia, very severe aortic stenosis, heart failure, and sick sinus syndrome who developed recurrent meal\u2010triggered syncope after discharge. Holter monitoring documented multiple prolonged sinus pauses during hospitalization. Given frailty, comorbidities, and the family's preference to avoid rehospitalization, pacemaker implantation was not pursued. Cilostazol 100\u2009mg twice daily was initiated in home\u2010based care, resulting in complete resolution of syncope over 10\u2009months without adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cilostazol may represent a noninvasive therapeutic option for carefully selected patients with probable swallow syncope when pacemaker implantation is not concordant with goals of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgf2.70147","type":"journal-article","created":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:44:28Z","timestamp":1783226668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cilostazol for Probable Swallow Syncope Associated With Sick Sinus Syndrome in a Nonagenarian Receiving Home\u2010Based Care: A Case Report"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7435-5234","authenticated-orcid":false,"given":"Hiromitsu","family":"Yamashita","sequence":"first","affiliation":[{"name":"Kawakita Family Clinic Minamiasagaya  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Shakya","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kawakita General Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayoshi","family":"Shiota","sequence":"additional","affiliation":[{"name":"Kawakita Family Clinic Minamiasagaya  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-019-1174-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2010.969"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2019.03.007"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm.2020.03.22"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/147323000403200513"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12649"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-24-0960"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90578-6"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-4943(96)86940-8"},{"issue":"468","key":"e_1_2_12_12_1","first-page":"575","article-title":"James Mackenzie Lecture. Trust\u2014In General Practice","volume":"51","author":"Fugelli P.","year":"2001","journal-title":"British Journal of General Practice"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-684X-12-7"}],"container-title":["Journal of General and Family Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgf2.70147","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgf2.70147","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgf2.70147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:53:29Z","timestamp":1785135209000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgf2.70147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/jgf2.70147"],"URL":"https:\/\/doi.org\/10.1002\/jgf2.70147","archive":["Portico"],"relation":{},"ISSN":["2189-7948","2189-7948"],"issn-type":[{"value":"2189-7948","type":"print"},{"value":"2189-7948","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70147"}}