{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:23:12Z","timestamp":1790198592211,"version":"4.1.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vasovagal Syncope (VVS) is a transient loss of consciousness caused by reflex vasodilatation and\/or bradycardia, typically triggered by orthostatic stress, emotion, or pain. It is the most common form of neurally mediated syncope, carries a benign prognosis, yet recurrent episodes impair quality of life and require risk stratification and tailored management. The Index of Cardiac Electrophysiological Balance (ICEB) is a novel index designed to quantify the ventricular depolarization\u2014repolarization electrophysiological balance and exhibits a bidirectional relationship with autonomic nervous function. In this study, we investigated the changes in ICEB among patients with VVS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The clinical data of 266 patients with VVS, confirmed by Head-up tilt test (HUTT) at Shaanxi Provincial People's Hospital from August 2021 to February 2025 were retrospectively collected as study group. A total of 201 healthy individuals who completed routine physical examinations during the same period were enrolled as the control group. Electrocardiogram (ECG) parameters (RR, P, QRS, QT) and ICEB were calculated and statistical analyzed during the HUTT in 5-minute supine phase or at rest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The QT interval, corrected QT (QTc) interval, ICEB and corrected ICEB (ICEBc) were lower (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001, respectively) in VVS group than in control group, with Type 2 showing the lowest level, even lower than those in Type 1 and Type 3. Pearson's correlation coefficient indicated that there was no significant correlation between the shortened cardiac electrophysiological parameters and asystole duration in Type 2. After adjusting for age, sex, body mass index, systolic blood pressure and diastolic blood pressure, VVS patients still had significantly lower ICEB, ICEBc compared with the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our study, we tried to demonstrate the relationship between ICEB and VVS confirmed by HUTT. We indicate that ICEB and ICEBc were shortened in patients with VVS at baseline, which may be attributed to autonomic dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1743842","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:25:06Z","timestamp":1773725106000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Index of cardiac electrophysiological balance in patients with vasovagal syncope confirmed by head-up tilt test"],"prefix":"10.3389","volume":"13","author":[{"given":"Lifei","family":"Tian","sequence":"first","affiliation":[{"name":"Department of General Surgery, Shaanxi Provincial People\u2019s Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Cardiac Function, Xi\u2019an Third Hospital\/Affiliated Hospital of Northwest University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Function, Shaanxi Provincial People s Hospital","place":["\u2019, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Cardiac Function, Shaanxi Provincial People s Hospital","place":["\u2019, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.vascn.2013.01.003","article-title":"A new biomarker\u2013index of cardiac electrophysiological balance (iCEB)\u2013plays an important role in drug-induced cardiac arrhythmias: beyond QT-prolongation and torsades de pointes 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