RESUMO
BACKGROUND: The Group for Syncope Study in the Emergency Room (GESINUR) was a Spanish multicenter, prospective, observational study that evaluated the clinical presentation and acute management of loss of consciousness in Spain. Several studies have shown that an abnormal ECG is a poor prognostic factor in patients with syncope. However, the prognostic significance of each ECG abnormality is not well known. OBJECTIVE: The purpose of this study was to study the association between specific ECG abnormalities and mortality in patients with syncope from the GESINUR study. METHODS: All patients in the GESINUR study who had syncope and had available, readable ECG and 12-month follow-up data were included in this retrospective observational study (n = 524, age 57 ± 22 years, 50.6% male). ECG abnormalities were analyzed and assessed to evaluate whether an association with all-cause mortality existed at 12 months. RESULTS: ECGs were classified as abnormal in 344 patients (65.6%). Thirty-three patients died during follow-up (6.3%), but only 1 due to sudden cardiovascular death. Atrial fibrillation (odds ratio [OR] 6.8, 95% confidence interval [CI] 2.8-16.3, P <.001), intraventricular conduction disturbances (OR 3.8, 95% CI 1.7-8.3, P = .001), left ventricular hypertrophy ECG criteria (OR 6.3, 95% CI 1.5-26.3, P = .011), and ventricular pacing (OR 21.8, 95% CI 4.1-115.3, P <.001) were the only independent ECG predictors of all-cause mortality. CONCLUSION: Although an abnormal ECG in patients with syncope is a common finding, only the presence of atrial fibrillation, intraventricular conduction disturbances, left ventricular hypertrophy ECG criteria, and ventricular pacing is associated with 1-year all-cause mortality.
