Annals of Emergency Medicine
Volume 51, Issue 3 , Pages 240-246.e1 , March 2008

Low Diagnostic Yield of Electrocardiogram Testing in Younger Patients With Syncope

  • Benjamin C. Sun, MD, MPP

      Affiliations

    • Department of Medicine, West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA
    • Department of Medicine, University of California, Los Angeles, Los Angeles, CA
    • Corresponding Author InformationAddress for correspondence: Benjamin Sun, MD, MPP, Office 3214A, Mail Stop 111, Building 500, Wing 3E, West Los Angeles Veterans Affairs Medical Center, 11301 Wilshire Blvd, Los Angeles, CA 90073; 310-268-3002, fax 310-268-4818
    • ,
  • Jerome R. Hoffman, MA, MD

      Affiliations

    • Emergency Medicine Center, University of California, Los Angeles, Los Angeles, CA
    • ,
  • William R. Mower, MD, PhD

      Affiliations

    • Emergency Medicine Center, University of California, Los Angeles, Los Angeles, CA
    • ,
  • Gil Z. Shlamovitz, MD

      Affiliations

    • Emergency Medicine Center, University of California, Los Angeles, Los Angeles, CA
    • ,
  • Gelarah Z. Gabayan, MD

      Affiliations

    • Emergency Medicine Center, University of California, Los Angeles, Los Angeles, CA
    • GZ Gabayan originally submitted this article under the name Gelarah Zargaraff.
    • ,
  • Carol M. Mangione, MD, MSPH

      Affiliations

    • Department of Medicine, University of California, Los Angeles, Los Angeles, CA
    • School of Public Health, University of California, Los Angeles, Los Angeles, CA.

Received 17 January 2007 ,Revised 14 March 2007 ,Accepted 6 April 2007.

References 

  1. Sun BC, Emond JA, Camargo CA. Characteristics and admission patterns of patients presenting with syncope to U.S. emergency departments, 1992-2000. Acad Emerg Med. 2004;11:1029–1034
  2. American College of Emergency Physicians. Clinical policy: critical issues in the evaluation and management of patients presenting with syncope. Ann Emerg Med. 2001;37:771–776
  3. Kapoor WN. Syncope. N Engl J Med. 2000;343:1856–1862
  4. Linzer M, Yang EH, Estes NA, et al. Diagnosing syncope (Part 1: value of history, physical examination, and electrocardiography. Clinical Efficacy Assessment Project of the American College of Physicians). Ann Intern Med. 1997;126:989–996
  5. Brignole M, Alboni P, Benditt D, et al. Guidelines on management (diagnosis and treatment) of syncope. Eur Heart J. 2001;22:1256–1306
  6. Strickberger SA, Benson DW, Biaggioni I, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation. 2006;113:316–327
  7. Sun BC, Emond JA, Camargo CA. Inconsistent electrocardiographic testing for syncope in United States emergency departments. Am J Cardiol. 2004;93:1306–1308
  8. Sun BC, Mangione CM, Merchant G, et al. External validation of the San Francisco Syncope Rule. Ann Emerg Med. 2007;49:420–427
  9. Cha S, Bagniewski S, Senspe BS. Mayo Clinic Division of Biostatistics. Available at: http://mayo.research.mayo.edu/mayo/research/biostat/sasmacros.cfm. Accessed April 16, 2006.
  10. Quinn JV, Stiell IG, McDermott DA, et al. Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med. 2004;43:224–232
  11. Sarasin FP, Louis-Simonet M, Carballo D, et al. Prospective evaluation of patients with syncope: a population-based study. Am J Med. 2001;111:177–184

 Supervising editor: Allan B. Wolfson, MDAuthor contributions: BCS, JRH, WRM, and CMM conceived the study. BCS and CMM obtained funding for this study. BCS, GZS, and GZG were responsible for data collection and outcomes review, and BCS supervised the overall data collection process. BCS performed the data analysis and drafted the article. All authors contributed substantially to article revisions. BCS takes responsibility for the paper as a whole.Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was supported by the UCLA Robert Wood Johnson Clinical Scholars Program (050721). Dr. Sun is supported by a UCLA National Institute of Aging K12 Award (K12AG001004) and an American Geriatrics Society Dennis Jahnigen Career Development Award. Dr. Mangione was also partially supported by the UCLA Center for Health Improvement in Minority Elders/Resource Centers for Minority Aging Research, NIH/NIA (AG 02-004).Publication dates: Available online June 7, 2007.Reprints not available from the authors.

PII: S0196-0644(07)00451-9

doi: 10.1016/j.annemergmed.2007.04.006

Annals of Emergency Medicine
Volume 51, Issue 3 , Pages 240-246.e1 , March 2008

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