{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:26:00Z","timestamp":1740137160394,"version":"3.37.3"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,21]],"date-time":"2021-08-21T00:00:00Z","timestamp":1629504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The Sudden Cardiac Death\u2010Screening of Risk FactOrS survey included a 12\u2010lead electrocardiogram (ECG) plus a digital\u2010based questionnaire and aimed to screen for warning signs of diseases that may course with sudden cardiac death in children and young adults. We aimed to estimate the prevalence of unexplained syncope (US) and characterize its high\u2010risk features and predictors in this cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We determined the most probable etiology of transient loss of consciousness (TLOC) episodes based on clinical criteria. US was an exclusion diagnosis and we analyzed its potential clinical and ECG predictors. Among 11\u2009878 individuals, with a mean age of 21\u2009\u00b1\u20096 (range 6\u201340) years old, the cumulative incidence of TLOC was 26.5%, 76.2% corresponding to females. Reflex syncope was present in 66.4%, orthostatic hypotension in 8.2%, and 14.8% of the individuals had US. Unexplained syncope was independently associated with age\u2009&lt;\u200918 years old (odds ratio [OR] 1.695; 95% confidence interval [CI] 1.26\u20132.29, <jats:italic>p<\/jats:italic>\u2009=\u2009.001), male gender (OR 1.642; 95% CI 1.22\u20132.22, <jats:italic>p<\/jats:italic>\u2009=\u2009.001), participation in competitive sports (OR 1.644; 95% CI 1.01\u20132.66, <jats:italic>p<\/jats:italic>\u2009=\u2009.043), syncope during exertion and\/or palpitations preceding syncope (OR 2.556; 95% CI 1.92\u20133.40, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), syncope after exertion (OR 2.662; 95% CI 1.73\u20134.10, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), fever context (OR 9.606; 95% CI 4.13\u201322.34, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), isolated previous syncopal episode (OR 2.780; 95% CI 0.2.06\u20133.75, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and history of palpitations requiring medical care (OR 1.945; 95% CI 1.14\u20133.31, <jats:italic>p<\/jats:italic>\u2009=\u2009.014). We found no ECG predictors of US in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The cumulative incidence of TLOC in children and young adults is high and remains unexplained in an important proportion of individuals. We identified eight clinical characteristics that may be useful for the risk stratification of individuals evaluated in a nonacute setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15204","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T14:28:22Z","timestamp":1628692102000},"page":"2737-2745","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High\u2010risk features and predictors of unexplained syncope in the young SCD\u2010SOS cohort"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4491-5312","authenticated-orcid":false,"given":"Mafalda","family":"Carrington","sequence":"first","affiliation":[{"name":"Department of Cardiology Hospital do Esp\u00edrito Santo de \u00c9vora  \u00c9vora Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Pais","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital do Esp\u00edrito Santo de \u00c9vora  \u00c9vora Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diogo","family":"Br\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital do Esp\u00edrito Santo de \u00c9vora  \u00c9vora Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7743-0143","authenticated-orcid":false,"given":"Antonio","family":"Creta","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, University College of London, St Bartholomew's Hospital, Barts Heart Centre Farr Institute of Health Informatics  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rog\u00e9rio","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Cardiology department of Centro Hospitalar Universit\u00e1rio de Coimbra Faculdade de Medicina da Universidade de Coimbra  Coimbra Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lino","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Cardiology department of Centro Hospitalar Universit\u00e1rio de Coimbra Faculdade de Medicina da Universidade de Coimbra  Coimbra Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-9883","authenticated-orcid":false,"given":"Rui","family":"Provid\u00eancia","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, University College of London, St Bartholomew's Hospital, Barts Heart Centre Farr Institute of Health Informatics  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00491-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv059"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht509"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-017-2221-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-311673"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2004.07.011"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy037"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000237"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.015"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jacc.2008.12.014","article-title":"AHA\/ACCF\/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. 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