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Pathophysiology of Vasovagal Syncope: Conclusive Remarks

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Vasovagal Syncope

Abstract

The vasovagal reflex, underlying vasovagal syncope (VVS), is likely to be an effective defence mechanism both in animals and humans. Within the vasovagal reflex, the vaso-inhibitory component plays a major role accounting for the limited efficacy of pacemaker implant in preventing VVS relapse, even if asystole has been previously documented by internal loop recordings. An effective neural sympathetic control of arterial vasculature upon standing is obtained in humans by both a proper increase of the sympathetic bursts activity and a baroreceptor mediated sympathetic neural discharge rhythmicity at 0.1 Hz. Adenosine and B-type natriuretic peptides are promising markers to be used in typifying clinical forms of VVS, their aetiology and prognosis. Although vagal activity is usually thought to be protective for the heart and brain, an excessive vagal activity resulting from the combination of diving and emotional VV reflexes or from a prolonged and forced head-up position may be harmful for humans.

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Author information

Authors and Affiliations

  1. Internal Medicine, Humanitas Clinical and Research Center, Via Manzoni, 56, Rozzano (MI), 20089, Italy

    Raffaello Furlan MD

  2. Department of Medical Biotechnology and Translational Medicine, University of Milan, Via Manzoni, 56, Rozzano (MI), 20089, Italy

    Raffaello Furlan MD

  3. Unità Sincopi e Disturbi della Postura, Medicina Interna 4 – Clinica Medica, Humanitas Research Hospital, Università degli Studi di Milano, Via Manzoni, 56, Rozzano (MI), 20089, Italy

    Raffaello Furlan MD

  4. Section of Cardiology and Syncope Unit, Ospedale Privato Quisisana, Viale Cavour, 128, Ferrara, 44121, Italy

    Paolo Alboni

  5. Department Clinical Pharmacology, Early Clinical Development Covance, Inc., 206 Carnegie Center, Princeton, NJ, 08540-6233, USA

    Rogelio Mosqueda-Garcia

Authors
  1. Raffaello Furlan MD
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  2. Paolo Alboni
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  3. Rogelio Mosqueda-Garcia
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Correspondence to Raffaello Furlan MD .

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Editors and Affiliations

  1. Section of Cardiology, Ospedale Privato Quisisana, Ferrara, Italy

    Paolo Alboni

  2. Department of Medicine - BIOMETRA, Humanitas Research Hospital, Rozzano, Milan, Italy

    Raffaello Furlan

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Furlan, R., Alboni, P., Mosqueda-Garcia, R. (2015). Pathophysiology of Vasovagal Syncope: Conclusive Remarks. In: Alboni, P., Furlan, R. (eds) Vasovagal Syncope. Springer, Cham. https://doi.org/10.1007/978-3-319-09102-0_9

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  • DOI: https://doi.org/10.1007/978-3-319-09102-0_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09101-3

  • Online ISBN: 978-3-319-09102-0

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