Atenolol for vasovagal syncope

Canadian Medical Association Journal 1996; 154: 1219

Source: Mahanonda N, Bhuripanyo K, Kangkagate C et al: Randomized double-blind, placebo-controlled trial of oral atenolol in patients with unexplained syncope and positive upright tilt table test results. Am Heart J 1995; 130: 1250-1253

Researchers in Bangkok conducted a randomized controlled trial to determine the effectiveness of oral atenolol therapy for vasovagal syncope. Forty-two patients who had experienced at least one episode of syncope or two episodes of presyncope in the previous month and who had a positive upright tilt-table test result with isoproterenol infusion were treated for 4 weeks with atenolol (50 or 100 mg/d) or a placebo. Outcome was measured by repeat tilt-table test. By intention-to-treat analysis 62% of the treatment group, as compared with only 5% of the placebo group, had a negative tilt-table test result (p = 0.0004); 71% of the treatment group and 21% of the placebo group reported feeling better (p = 0.02). The treatment group also had a significant reduction in the weekly frequency of syncope. No significant differences were seen bettween the groups in systolic and diastolic blood pressures or in heart rate, and no serious side effects were reported.

| CMAJ April 15, 1996 (vol 154, no 8) |