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Q In patients with vasovagal syncope, does training in physical counterpressure manoeuvres reduce recurrent syncope?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Neurology ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Cardiology ★★★★☆☆☆
METHODS
Design:
randomised controlled trial (Physical Counterpressure Manoeuvres Trial).
Allocation:
concealed.*
Blinding:
blinded (patients).*
Follow up period:
mean 14 months.
Setting:
15 medical centres worldwide.
Patients:
223 patients who were 16–70 years of age with recurrent vasovagal syncope (⩾3 syncope episodes in the past 2 y or ⩾1 syncopal spell and 3 pre-syncopal episodes in the past y) or a suspected diagnosis confirmed by tilt table testing and who had recognisable prodromal symptoms and a normal physical examination and electrocardiogram. Exclusion criteria included suspected or overt heart disease with a high likelihood of cardiac syncope; orthostatic hypotension; loss of consciousness different from syncope; the …
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