ArticleHeart rhythm2020
Skin sympathetic nerve activity as a biomarker for syncopal episodes during a tilt table test.
Article in Heart rhythm, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Index of cardiac electrophysiological balance in patients with vasovagal syncope confirmed by head-up tilt test.Frontiers in cardiovascular medicine · 2026Article
- Improved non-invasive detection of sleep stages when combining skin sympathetic nerve activity and heart rate variability analysis with AI.Scientific reports · 2025Article
- Skin sympathetic nerve activity during unprovoked syncope in an ambulatory patient with postural orthostatic tachycardia syndrome.Heart rhythm · 2024Article
- Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study.Scientific reports · 2024Article
- Autonomic dysfunction and treatment strategies in intracerebral hemorrhage.CNS neuroscience & therapeutics · 2024Review
- Automatic Detection and Characterization of Autonomic Dysreflexia Using Multi-Modal Non-Invasive Sensing and Neural Networks.Neurotrauma reports · 2022Article
- The Mechanism of Cardiac Sympathetic Activity Assessment Methods: Current Knowledge.Frontiers in cardiovascular medicine · 2022Review
- High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope.Journal of personalized medicine · 2021Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundAutonomic imbalance is the proposed mechanism of syncope during a tilt table test (TTT). We have recently demonstrated that skin sympathetic nerve activity (SKNA) can be noninvasively recorded using electrocardiographic electrodes.
objectiveThe purpose of this study was to test the hypothesis that increased SKNA activation precedes tilt-induced syncope.
methodsWe studied 50 patients with a history of neurocardiogenic syncope undergoing a TTT. The recorded signals were band-pass filtered at 500-1000 Hz to analyze nerve activity.
resultsThe average SKNA (aSKNA) value at baseline was 1.38 ± 0.38 μV in patients without syncope and 1.42 ± 0.52 μV in patients with syncope (P = .77). On upright tilt, aSKNA was 1.34 ± 0.40 μV in patients who did not have syncope and 1.39 ± 0.43 μV in patients who had syncope (P = .65). In all 14 patients with syncope, there was a surge of SKNA before an initial increase in heart rate followed by bradycardia, hypotension, and syncope. The peak aSKNA immediately (<1 minute) before syncope was significantly higher than baseline aSKNA (2.63 ± 1.22 vs 1.39 ± 0.43 μV; P = .0005). After syncope, patients were immediately placed in the supine position and aSKNA dropped significantly to 1.26 ± 0.43 μV; (P = .0004). The heart rate variability during the TTT shows a significant increase in parasympathetic tone during syncope (low-frequency/high-frequency ratio: 7.15 vs 2.21; P = .04).
conclusionPatients with syncope do not have elevated sympathetic tone at baseline or during the TTT except immediately before syncope when there is a transient surge of SKNA followed by sympathetic withdrawal along with parasympathetic surge.
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