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Efficacy and safety of midodrine hydrochloride in patients with refractory vasovagal syncope

2001; Elsevier BV; Volume: 88; Issue: 1 Linguagem: Inglês

10.1016/s0002-9149(01)01594-6

1879-1913

Nemer Samniah, Scott Sakaguchi, Keith G. Lurie, Demosthenes Iskos, David G. Benditt,

Heart Rate Variability and Autonomic Control

Midodrine hydrochloride is a peripheral α-receptor agonist capable of inducing venous and arterial vasoconstriction. 1 McTavish D. Goa K.L. Midodrine a review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders. Drugs. 1989; 38: 757-777 Crossref PubMed Scopus (151) Google Scholar , 2 Benditt D. Fahy G. Lurie K. Sakaguchi S. Fabian W. Samniah N. Pharmacotherapy of neurally mediated syncope. Circulation. 1999; 100: 1242-1248 Crossref PubMed Scopus (83) Google Scholar , 3 Koyama S. Matsubara T. Aizawa Y. Ohshima M. Yamaguchi T. Igarashi Y. Tamura Y. Yamazoe M. Isumi T. Shibata A. Tanaka Y. Watanabe K. A case of vasovagal syncope with convulsions-the effects of midodrine hydrochloride. Jpn Circ J. 1992; 56: 950-954 Crossref PubMed Scopus (10) Google Scholar , 4 Ward C. Kenny R.A. Observation on midodrine in a case of vasodepressor neurogenic syncope. Clin Auton Res. 1995; 5: 257-260 Crossref PubMed Scopus (14) Google Scholar , 5 Sra J. Maglio C. Biehl M. Dahla A. Blanck Z. Deshpande S. Jazayeri M. Akhtar M. Efficacy of midodrine hydrochloride in neurocardiogenic syncope refractory to standard therapy. J Cardiovasc Electrophysiol. 1997; 8: 42-46 Crossref PubMed Scopus (64) Google Scholar , 6 Gilden J.L. Midodrine in neurogenic orthostatic hypotension. Int Angiol. 1993; 12: 125-131 PubMed Google Scholar , 7 Low P.A. Gilden J.L. Freeman R. Sheng K.N. McElligott M.A. Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension. A randomized, double-blinded multicenter study. JAMA. 1997; 227: 1046-1051 Crossref Google Scholar , 8 Benditt D.G. Ferguson D.W. Grubb B.P. Kapoor W. Kugler J. Lerman B. Maloney J. Raviele A. Ross B. Sutton R. Wolk M.J. Wood D.L. Tilt-table testing for assessing syncope and its treatment an American College of Cardiology expert consensus document. J Am Coll Cardiol. 1996; 28: 263-275 Abstract Full Text PDF PubMed Scopus (553) Google Scholar , 9 Sra J.S. Jazayeri M.R. Dahla A. Deshpande S. Blanck Z. Akhtar M. Neurocardiogenic syncope diagnosis, mechanisms, and treatment. Cardiol Clin. 1993; 11: 183-191 PubMed Google Scholar , 10 Ward C.R. Gray J.C. Gilroy J.J. Kenny R.A. Midodrine hydrochloride in the management of neurocardiogenic syncope. Heart. 1998; 79: 45-49 PubMed Google Scholar As a result of this action, midodrine has been approved in the United States for treatment of orthostatic hypotension, and several reports attest to its effectiveness in that setting. 6 Gilden J.L. Midodrine in neurogenic orthostatic hypotension. Int Angiol. 1993; 12: 125-131 PubMed Google Scholar , 7 Low P.A. Gilden J.L. Freeman R. Sheng K.N. McElligott M.A. Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension. A randomized, double-blinded multicenter study. JAMA. 1997; 227: 1046-1051 Crossref Google Scholar In addition, other studies suggest that, at least during short-term follow-up, midodrine may also be effective as a preventive measure in patients with vasovagal syncope. 3 Koyama S. Matsubara T. Aizawa Y. Ohshima M. Yamaguchi T. Igarashi Y. Tamura Y. Yamazoe M. Isumi T. Shibata A. Tanaka Y. Watanabe K. A case of vasovagal syncope with convulsions-the effects of midodrine hydrochloride. Jpn Circ J. 1992; 56: 950-954 Crossref PubMed Scopus (10) Google Scholar , 4 Ward C. Kenny R.A. Observation on midodrine in a case of vasodepressor neurogenic syncope. Clin Auton Res. 1995; 5: 257-260 Crossref PubMed Scopus (14) Google Scholar , 5 Sra J. Maglio C. Biehl M. Dahla A. Blanck Z. Deshpande S. Jazayeri M. Akhtar M. Efficacy of midodrine hydrochloride in neurocardiogenic syncope refractory to standard therapy. J Cardiovasc Electrophysiol. 1997; 8: 42-46 Crossref PubMed Scopus (64) Google Scholar , 10 Ward C.R. Gray J.C. Gilroy J.J. Kenny R.A. Midodrine hydrochloride in the management of neurocardiogenic syncope. Heart. 1998; 79: 45-49 PubMed Google Scholar This report extends prior experience with midodrine as a therapeutic measure in patients with refractory recurrent vasovagal syncope.