Guidelines for the Diagnosis and Management of Syncope (Version 2009)

This is a revised version of the former 2004 ESC Guidelines on Syncope. Dr. Andrew Krahn represented the Heart Rhythm Society on this document.

The most relevant changes from the version in 2004 were:

• An update of the classification of syncope in the larger framework of transient loss of consciousness (T-LOC)
• New data on epidemiology
• A new diagnostic approach focusing on risk stratification of sudden cardiac death (SCD) and cardiovascular events after initial evaluation, including some recommendations for treatment in patients with unexplained syncope at high risk
• Emphasis on the increasing role of a diagnostic strategy based on prolonged monitoring in contrast to the conventional strategy based on laboratory testing
• An update of evidence-based therapy

One of the main aspects found in this version, which differs from its predecessors; is the concept that there are two distinct reasons for evaluating patients with syncope:

• Identification of the precise cause in order to address an effective mechanism specific treatment
• Identification of the specific risk to the patient, which frequently depends on the underlying disease rather than on the mechanism of syncope itself

Related Documents
Guidelines on Management (Diagnosis and Treatment) of Syncope — Update 2004; The Task Force on Syncope, European Society of Cardiology. Download executive summary (PDF, 336K)