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Preliminary observations on the use of midodrine hydrochloride in the treatment of refractory neurocardiogenic syncope.

Abstract
Recurrent episodes of neurocardiogenic syncope that occur without warning are a common cause of recurrent syncope that can be identified during head upright tilt table testing. While the use of beta blockers, theophyllines, fludrocortisone, disopyramide, and serotonin reuptake inhibitors can be useful in the prevention of episodes, some patients are either unresponsive to or poorly tolerant of these agents. We investigated the use of the peripheral alpha stimulating agent midodrine in preventing both tilt-induced and spontaneous neurocardiogenic syncope. Twenty-five patients (16 women, 9 men, mean age 30 +/- 23 years) with severe recurrent syncope and a positive head upright tilt table study (refractory to or intolerant of standard therapies) were placed on midodrine 5-10 mg orally three times per day, (two patients required 15 mg/day). Of these, twelve became asymptomatic and five had a marked reduction in symptoms. We conclude that midodrine may be an effective therapy in patients with recurrent neurocardiogenic syncope refractory to other forms of therapy.
AuthorsB P Grubb, B Karas, D Kosinski, K Boehm
JournalJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (J Interv Card Electrophysiol) Vol. 3 Issue 2 Pg. 139-43 (Jul 1999) ISSN: 1383-875X [Print] Netherlands
PMID10387140 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Adrenergic alpha-Agonists
  • Midodrine
Topics
  • Administration, Oral
  • Adolescent
  • Adrenergic alpha-Agonists (adverse effects, therapeutic use)
  • Adult
  • Aged
  • Autonomic Nervous System Diseases (complications)
  • Female
  • Heart Diseases (complications)
  • Humans
  • Male
  • Middle Aged
  • Midodrine (adverse effects, therapeutic use)
  • Recurrence
  • Syncope (diagnosis, etiology, prevention & control)
  • Tilt-Table Test
  • Treatment Outcome

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