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07. Syncope and Bradycardia
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The applicability of FAINT score in syncope study and prediction of pacemaker implantation.
Session:
Posters (Sessão 3 - Écran 3) - Arrítmias 4 - Vários
Speaker:
Gonçalo Rm Ferreira
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
07. Syncope and Bradycardia
Subtheme:
07.2 Syncope and Bradycardia - Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Gonçalo rm Ferreira; Luísa Gonçalves; Inês Pires; João Miguel Santos; Joana Correia; Vanda Neto; João Fiuza; João Corrêa; Gabriela Venade; Bruno Marmelo; Miguel Correia; Júlio Gil Pereira; Luís Santos; António Costa; Costa Cabral
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="color:#222222"><span style="background-color:#ffffff"><span style="font-family:Calibri,sans-serif">INTRODUCTION: Unexplained syncope is a challenging working diagnosis. Implantable loop recorder (ILR) is useful when syncope is rare, and the FAINT score is a risk stratification tool used to predict adverse cardiac events at 30 days in patients who are admitted with syncope in the emergency department.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#222222"><span style="background-color:#ffffff"><span style="font-family:Calibri,sans-serif">OBJECTIVE: To evaluate the applicability of the FAINT score in patients with a syncope working diagnosis and its capacity of identifying those with a higher risk of pacemaker (PM) implantation.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#222222"><span style="background-color:#ffffff"><span style="font-family:Calibri,sans-serif">METHODS: Selected all patients with an implanted ILR for syncope working diagnosis during 5 consecutive years, in a cardiology department. Patients were selected for ILR implantation after syncope and hospital admission (cardiology ward or emergency department). The FAINT score was calculated (F – history of heart failure, 1 point; A – history of arrhythmia, 1 point; I – abnormal initial electrocardiogram, 1 point; N – elevated natriuretic peptides, 2 points; T – elevated troponin, 1 point). The risk was stratified by FAINT score: high risk ≥ 1 and lower risk = 0. Patients were split into two groups: High-risk FAINT patients (HF) and Low-risk FAINT patients (LF) and were compared, using Pearson’s Chi-Square test, Fisher’s Exact Test, logistic regression, and odds-ratio chances. Follow-up for up to four years. The primary endpoint was defined as the need for PM implantation during follow-up. Adverse events like ILR complication or death were assessed.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#222222"><span style="background-color:#ffffff"><span style="font-family:Calibri,sans-serif">RESULTS: 55 patients were included in the final analysis. 50.9% females (n=28). Mean age of 59.18 [18-86 years]. HF group in 41.8% (n=23) and LF group in 58.2% (n=32). Medium FAINT score of 0.8 [0-5 points]. PM implantation in 27.3% (n=15) during follow-up. Medium follow-up of 979 [0-1701<span style="font-size:12pt"> days</span>]. 5.5% (n=3) of ILR complications. 7.3% of mortality during follow-up. Compared to the LF group, patients in the HF group more frequently had PM implantation (45% vs 18.8%, p=0.04). Although only 4 patients died during the follow-up, there was a significant difference between groups, as all of the patients who died were in the HF group (p=0.03). For each point in the FAINT score, the risk of PM implantation increases 2.09 times (p<0.01). The odds ratio of PM implantation in the high-risk patient is 3.54 higher (p=0.04) than that of the low-risk patients. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="color:#222222"><span style="background-color:#ffffff"><span style="font-family:Calibri,sans-serif">DISCUSSION: Although the FAINT score is currently used to evaluate the short-term risk of adverse cardiac events after syncope, in our study, it proved to be a useful tool for stratifying the risk of PM implantation on the long-term follow-up.</span></span></span></span></p>
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