ArticleHeart rhythm O22026
Association between deceleration capacity-quantified vagal tone and vasovagal syncope patients with different responses to head-up tilt test.
Article in Heart rhythm O2, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Vasovagal syncope (VVS) involves autonomic dysregulation. Cardiac deceleration capacity (DC) is a metric of vagal activity with potential application in VVS. Although the head-up tilt test (HUT) categorizes VVS into vasodepressor, cardioinhibitory, and mixed subtypes, the characteristics of subtype-specific DC-quantified vagal tone remain unclear. Objective: This study aimed to investigate the relationship between DC and HUT-based VVS subtypes, elucidating discrepancies in vagal tone among patients with VVS. Methods: This observational study enrolled 264 patients with VVS and 127 asymptomatic controls. All participants underwent 24-hour Holter monitoring. Patients with VVS were classified by HUT responses. Multinomial logistic regression analysis was performed to assess DC's association with VVS subtypes. Receiver operating characteristic analysis was performed for DC to identify vasodepressor VVS. Results: Patients with VVS showed significantly higher DC than controls (8.28 ± 2.77 ms vs. 5.65 ± 1.07 ms; Conclusion: Enhanced DC-quantified vagal tone is differentially associated with VVS subtypes. DC could serve as a practical tool for VVS classification without reproducing syncopal symptoms, potentially guiding phenotype-specific therapeutic strategies for VVS.
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