Introduction: The benefits and physiological changes attributed to orthostatic training in vasovagal syncope (VVS) have never been evaluated against placebo. We studied the changes in baroreflex sensitivity (BRS) in response to home orthostatic training (HOT) in a randomized, placebo-controlled pilot study.
Methods: 22 subjects, aged 18 to 85 years, with recurrent VVS were randomized to daily HOT (n12) or sham training (n10) for 6 months. BRS was determined using the sequence method during 10 minutes’ supine rest at enrolment, week 1, week 4 and week 24. Syncope recurrence was assessed with event diaries.
Results: 6 (50%) subjects in the intervention group and 2 (20%) subjects in the placebo group were syncope free at week 24. Down slope and total BRS were significantly increased from baseline following one week of HOT therapy compared to placebo (median change 3.13 vs. -1.46 ms/mmHg, p0.05; 1.21 vs. -1.26 ms/mmHg, p0.05). Maximal improvements were observed at week 4 and sustained up to week 24.
Conclusion: Our pilot study demonstrated positive trends in symptom benefit and significant improvements in BRS with HOT in patients with VVS.