Syncope Clinic

Syncope Clinic

The focus of the clinic is to provide compassionate, patient-centred care with a focus on communication to improve the understanding and wellbeing of patients with Transient Loss of Conciousness [TLOC/Syncope].

Most episodes of loss of consciousness (syncope) are due to low blood Pressure.  However, it is important to make sure that, there is not a cardiac cause of syncope.  As part of Heart Rhythm Clinic, the Syncope Clinic is a leading program for evaluating and treating syncope.

Problems We Treat

We evaluate and care for cardiac-focused syncope that may be due to either previously undiagnosed structural heart disease or heart rhythm abnormalities.

Common Heart Rhythm Abnormalities which can cause Syncope are:

  1. Conduction system disorders like Sick Sinus Syndrome or AV block which can manifest either persistent Low heart rate or episodic low heart rate.
  1. Life threatening Ventricular arrhythmias – commonly due to old heart attack with poor pumping function or structurally normal heart with genetic arrhythmogenic disorders[Long/short QT  syndromes, Brugada syndrome, Catecholaminergic polymorphic ventricular tachycardia, etc]
  1. Supraventricular Tachycardia’s.

We also evaluate and manage the most common causes for syncope like neurally mediated syncope [like Vasovagal / common faint], Orthostatic Hypotension and Postural Orthostatic Tachycardia Syndrome [POTS].

What to Expect

Our Heart Rhythm specialist team  a doctor, Physician assistant  and nurse practitioner, who specialize in assessing, diagnosing, and treating syncope, will do the initial evaluation by taking your history  followed by  physical exam, orthostatic BP recordings, and ECG to determine the best course of treatment for your condition. Further testing including Echocardiogram, Blood testing and exercise stress testing may be indicated based on the initial evaluation and findings. After initial evaluation, if indicated Neurologist evaluation and opinion also will be taken.

What are Specialized Investigations done for Syncope? 

  1. Holter Monitoring -24hrs
  2. External loop recorders for 3 day to 14 days
  3. Insertable loop Recorders [ILR]
  4. Carotid Sinus Massage
  5. Head Up Tilt table test [HUTT]
  6. Electrophysiology Study[EP Study]

What are Treatment Options for Cardiac Syncope?

  1. Permanent Pacemaker Implantation –if syncope related to low heart rate
  2. AICD[Automatic Cardioverter Defibrillator Implantation]- if syncope related to life threatening ventricular arrhythmias
  3. Electrophysiology study and RF ablation – if syncope related to Supraventricular arrhythmias, etc


What are the Treatment Options for Neurally mediated common faint?

  1. Counselling and Education of Preventive Measures
  2. Pacemaker implantation in rare cases

Dr. A.M.Karthigesan

-Senior Consultant Cardiologist & Electrophysiologist

-Chief, Cardiac Pacing and Arrhythmia Services

-Department of Cardiac Pacing and Electrophysiology

-Apollo Hospitals, Greams Road, Chennai.

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