{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T10:27:03Z","timestamp":1791023223921,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"s9","license":[{"start":{"date-parts":[[2003,9,5]],"date-time":"2003-09-05T00:00:00Z","timestamp":1062720000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p>\n                    Evidence for therapy of neurally mediated syncope is generally weak. Many drugs have been used for the treatment of vasovagal syncope (beta\u2010blockers, disopyramide, scopolamine, clonidine, theophylline, fludrocortisone, ephedrine, dihydroergotamine, etilefrine, midodrine, clonidine, serotonin reuptake inhibitors, enalapril). In general, although the results have been satisfactory in uncontrolled trials or short\u2010term controlled trials, the majority of long\u2010term placebo\u2010controlled prospective trials have not been able to show a benefit of the active drug over placebo. Only two well\u2010designed double\u2010blind placebo\u2010controlled randomized trials have been performed\u2014one for etilefrine and the other for atenolol\u2014and both were unable to show a superiority of the active drug versus placebo. Four randomized clinical trials of pacing therapy\u2014three positive and one negative\u2014have been performed in patients affected by vasovagal syncope. The relationship between carotid sinus hypersensitivity and spontaneous, otherwise unexplained, syncope has been demonstrated. Cardiac pacing appears to be beneficial in carotid sinus syndrome; its efficacy has been demonstrated by two randomized controlled trials and confirmed by several pre\u2010post comparative studies, one controlled trial, and one prospective observational study. There is evidence and general agreement that cardiac pacing is useful in patients with cardioinhibitory or mixed carotid sinus syndrome. Usefulness of the treatment is less well established and divergence of opinion exists with regard to cardiac pacing in patients with cardioinhibitory vasovagal syncope. The evidence fails to support the efficacy of beta\u2010blocking drugs. As yet there are insufficient data to support the use of any other pharmacologic therapy for vasovagal syncope.\n                    <jats:italic>(J Cardiovasc Electrophysiol, Vol. 14, pp. S64\u2010S69, September 2003, Suppl.)<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1046\/j.1540-8167.14.s9.7.x","type":"journal-article","created":{"date-parts":[[2010,8,16]],"date-time":"2010-08-16T05:46:28Z","timestamp":1281937588000},"source":"Crossref","is-referenced-by-count":35,"title":["Randomized Clinical Trials of Neurally Mediated Syncope"],"prefix":"10.1111","volume":"14","author":[{"given":"MICHELE","family":"BRIGNOLE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,9,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.154.14.1613"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90245-8"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.77.3.268"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(95)90078-0"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00568-2"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90517-G"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(95)90150-7"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90615-6"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00359-1"},{"key":"e_1_2_6_11_2","first-page":"833","article-title":"Barsotti A: Effects of different treatments vs no treatment on neurocardiogenic syncope","volume":"43","author":"Di Gerolamo E","year":"1998","journal-title":"Cardiologia"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01155-4"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2002.t01-1-00816.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01974-5"},{"key":"e_1_2_6_15_2","first-page":"191","article-title":"A randomized trial of medical therapy in malignant vasovagal syndrome or neurally\u2010mediated bradycardia\/hypotension syndrome","volume":"1","author":"Fitzpatrick AP","year":"1991","journal-title":"Eur J Card Pacing Electrophysiol"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.11.1452"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00336-O"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.79.1.45"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2001.00935.x"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(93)90230-M"},{"key":"e_1_2_6_21_2","first-page":"125","article-title":"Midodrine in neurogenic orthostatic hypotension","volume":"12","author":"Gilden JL","year":"1993","journal-title":"Int Angiol"},{"key":"e_1_2_6_22_2","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1001\/jama.1997.03540370036033","article-title":"Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension","volume":"13","author":"Low PA","year":"1997","journal-title":"JAMA"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10293"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00694-9"},{"key":"e_1_2_6_25_2","first-page":"1500","article-title":"Serotonin reuptake inhibitor (Paxil) does not prevent the vasovagal reaction associated with carotid sinus massage and\/or lower body negative pressure in healthy volunteers","volume":"106","author":"Takata T","year":"2002","journal-title":"Pacing Clin Electrophysiol"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00342-6"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90767-U"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(98)70131-0"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-114-12-1013"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00549-X"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.3.294"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc2601.091708"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.17.2224"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc3601.095708"},{"key":"e_1_2_6_35_2","article-title":"International Study on Syncope of Uncertain Etiology 2 (ISSUE 2): The management of patients with suspected or certain neurally\u2010mediated syncope after the initial evaluation. 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