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Syncope treatment is tailored to your individual condition, since as we’ve seen, it can be the result of numerous conditions. Your treatment must address the underlying cause of syncope to be effective.
When syncope results from a vasovagal faint and you’re not in a high-risk category and don’t have any known cardiac disease, you can often be treated with education, lifestyle changes, usually with avoidance of long standing periods and increase in hydration, modification of your hypotensive medication (if any), and avoidance of triggering situations.
Other, more serious, cases of syncope are cardiovascular in nature, and we need to use one or more of the following therapies to stop or control it:
- If you’re not taking any cardiovascular medicines, we may start one or more. If you are taking them, we’ll evaluate your medication profile in its entirety, and will often make adjustments to it. Usually, we discontinue medications. Sometimes medication, along with small changes such as wearing special hosiery that improve circulation, can solve the problem of syncope with no other intervention.
- Treatment for a rapid heartbeat (tachycardia) depends on whether it occurs in the upper chambers (atria) or lower chambers (ventricles) of your heart. The irregular heart rhythms or underlying disease can be also controlled by medication.
- Pacemaker insertion is the most common treatment for syncope caused by a slow heartbeat (bradycardia). The pacemaker continuously monitors your heart's natural rhythm. It delivers an electrical impulse to stimulate, or pace, your heart's muscle contractions if your heart rate drops below a certain number of beats per minute.
- An implantable cardioverter defibrillator (ICD) is a device similar to a pacemaker, and it is used in patients with syncope who have underlying structural heart disease, and are therefore at high risk for ventricular tachycardia or ventricular fibrillation. It continually monitors the heart and delivers a life-saving shock if it detects a dangerous heart rhythm.
As with certain medications and the use of an ICD, the following procedure is used when arrhythmia that can be cured is thought to be the cause of syncope:
- Catheter ablation is a procedure in which we use x-ray guidance to insert several flexible tubes called catheters into your blood vessels and direct them to the heart muscle. Usually, we then release a burst of energy which destroys very small areas of tissue that cause abnormal electrical signals.