Fludrocortisone in Pediatric Vasovagal Syncope: A Retrospective, Single-Center Observational Study

ABSTRACT

Background@#and Purpose The purpose of this study was to determine the effect of fludrocortisone in patients with pediatric vasovagal syncope (VVS). @*Methods@#This retrospective observational single-tertiary-center study based on chart reviews included 74 patients who were newly diagnosed with VVS in the head-up tilt-table test (HUTT). Some of the patients had been treated with fludrocortisone. All patients were assessed using a brain and cardiac workup before treatment to rule out the syncope being due to other causes, which resulted in seven of them being excluded two for epilepsy and five for brain pathologies. The remaining 67 patients were analyzed. The effect of fludrocortisone was evaluated based on the results of a follow-up HUTT, with a response to the treatment considered to be present if there was a negative change at the follow-up HUTT. Univariate logistic regression were used for statistical analyses, with the criterion for significance being p<0.05. @*Results@#There were no significant differences in the characteristic of the patients between the no-medication (n=39) and fludrocortisone (n=28) groups, including age, sex, and duration of treatment. The recurrence rate of syncopal or presyncopal events was significantly lower in the fludrocortisone group (39.3%, 11 of 28) than in the no-medication group (64.1%, 25 of 39) (p=0.044), as was the rate of negative change at the follow-up HUTT 57.1% (16 of 28) and 28.2% (11 of 39), respectively (p=0.017). @*Conclusions@#Our findings suggest that fludrocortisone is more effective than no medication in pediatric patients with VVS.