{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:10:50Z","timestamp":1791447050778,"version":"4.3.3"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","award":["98\u20103\u2010101\u201043569"],"award-info":[{"award-number":["98\u20103\u2010101\u201043569"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Physical techniques used for the prevention of vasovagal syncope have limited evidence for efficacy. We aimed to evaluate multimodal supervised physical training as a treatment approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this 1:1 randomized trial, patients with \u22652 episodes of clinically diagnosed vasovagal syncope were included. On top of standard care, the intervention arm performed supervised tilt training and aerobic exercise in six sessions at a cardiac rehabilitation center (three sessions during the first month, and then at 3\u2010month intervals), plus home tilt training. The control arm received standard care with a similar protocol of home tilt training. The primary outcome was time to first syncopal recurrence during 1\u00a0year of follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty participants were randomized (mean age: 34.5\u2009\u00b1\u200914.8 years; 64% female). The rate of syncopal recurrence was 28% and 64% within the intervention and control arms, respectively, with significantly higher syncope\u2010free survival at 1\u00a0year in the intervention arm (Log\u2010rank <jats:italic>p<\/jats:italic>\u2009=\u2009.003). The frequency of recurrent syncopal events was significantly lower with physical training (<jats:italic>p<\/jats:italic>\u2009=\u2009.017). Participants in the intervention arm reported significantly higher adherence to the home tilt training program (80% vs. 52%; <jats:italic>p<\/jats:italic>\u2009=\u2009.037).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients with recurrent vasovagal syncope, a supervised program of tilt training and aerobic exercise reduced syncopal recurrence. Future trials are warranted to further investigate multimodal supervised physical techniques as a therapeutic approach in treating vasovagal syncope.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15578","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T08:10:48Z","timestamp":1653898248000},"page":"1863-1870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Implementation of supervised physical training to reduce vasovagal syncope recurrence: A randomized controlled trial"],"prefix":"10.1111","volume":"33","author":[{"given":"Faezeh","family":"Aghajani","sequence":"first","affiliation":[{"name":"Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran 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