SynthesisEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2022
Midodrine for the prevention of vasovagal syncope: a systematic review and meta-analysis.
Synthesis in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Serotonin reuptake inhibition for the prevention of vasovagal syncope: a systematic review and meta-analysis.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Pooled it
- Management of Syncope in Geriatric Patients: Are 2018 European Society of Cardiology Guidelines Still Relevant?Journal of clinical medicine · 2026Review
- Article
- Comparing Physical, Pharmacological, Pacemaker, and Cardioneuroablation Therapies for Patients with Vasovagal Syncope: A systematic review and networkInternational journal of cardiology. Heart & vasculature · 2026Article
- Article
- The Programmed Placebo Effect in Patients with Syncope: Preliminary Clinical and Nanostructural Insights with a Hypothetical Quantum-Level Interpretation.Journal of clinical medicine · 2025Article
- Haemodynamic effects of fludrocortisone and midodrine in patients with symptoms due to hypotension.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- The Efficacy of Cardioneuroablation versus Midodrine in Patients with Vasovagal Syncope: Design and Rationale for the CAMPAIGN Trial.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- The Mystery of Situational Syncope: A Case Series of Three Patients with Uncommon Histories.Research in heart yield and translational medicine · 2025Article
- The Role of the Autonomic Nervous System in Vasovagal Syncope.Cardiac electrophysiology clinics · 2024Review
- Suppression of sleep syncope and vagally-mediated asystole by norepinephrine transporter inhibitor.HeartRhythm case reports · 2024Article
- Serotonin and vasovagal syncope.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Review
- Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden.Nature reviews. Cardiology · 2024Review
- Cardioneuroablation as a strategy to prevent pacemaker implantation in young patients with vasovagal syncope.International journal of cardiology. Heart & vasculature · 2024Article
- Mechanism-based therapy of non-cardiac syncope: a practical guide.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Effectiveness analysis of deceleration capacity and traditional heart rate variability in diagnosing vasovagal syncope.Frontiers in cardiovascular medicine · 2024Article
- Vasovagal Syncope: A Review of Current and Emerging Therapies for a Common Cardiology Condition.The journal of Tehran Heart Center · 2024Article
- Serum uric acid predicts therapeutic response to midodrine hydrochloride in children with vasovagal syncope: a pilot study.European journal of pediatrics · 2024Article
- A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Twenty-five years of research on syncope.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
aimsVasovagal syncope (VVS) is a common clinical condition that lacks effective medical therapies despite being associated with significant morbidity. Current guidelines suggest that midodrine, a prodrug for an α1-adrenergic receptor agonist, might suppress VVS but supporting studies have utilized heterogeneous methods and yielded inconsistent results. To evaluate the efficacy of midodrine to prevent syncope in patients with recurrent VVS by conducting a systematic review and meta-analysis of published studies. METHODS AND
resultsRelevant randomized controlled trials were identified from the MEDLINE, Embase, CENTRAL, and CINAHL databases without language restriction from inception to June 2021. All studies were conducted in clinical syncope populations and compared the benefit of midodrine vs. placebo or non-pharmacological standard care. Weighted relative risks (RRs) were estimated using random effects meta-analysis techniques. Seven studies (n = 315) met inclusion criteria. Patients were 33 ± 17 years of age and 31% male. Midodrine was found to substantially reduce the likelihood of positive head-up-tilt (HUT) test outcomes [RR = 0.37 (0.23-0.59), P < 0.001]. In contrast, the pooled results of single- and double-blind clinical trials (I2 = 54%) suggested a more modest benefit from midodrine for the prevention of clinical syncope [RR = 0.51 (0.33-0.79), P = 0.003]. The two rigorous double-blind, randomized, placebo-controlled clinical trials included 179 VVS patients with minimal between-study heterogeneity (I2 = 0%) and reported a risk reduction with midodrine [RR = 0.71 (0.53-0.95), P = 0.02].
conclusionsMidodrine is effective in preventing syncope induced by HUT testing and less, but still significant, RR reduction in randomized, double-blinded clinical trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.