RANDOMIZED COMPARISON OF ATENOLOL AND FLUDROCORTISONE ACETATE IN THE TREATMENT OF PEDIATRIC NEURALLY-MEDIATED SYNCOPE

Tilt-table testing provides a reliable means for identifying children with neurally mediated syncope.(1,2) Limited information is available regarding the outcome of patients whose treatment is based on a positi ve tilt-table result,(3-6) and there are no published reports regardin g direct comparisons of treatments. It is not clear that the same type of patients comprise the treatment groups in prior studies since a va riety of selection criteria and tilt protocols have been used to diagn ose and treat neurally mediated syncope. We proposed to randomize a un iform cohort of pediatric patients to atenolol or fludro-cortisone ace tate to determine if there were significant differences in response. S econdary outcomes that were measured included the predictive value of acutely administered intravenous beta blockade for long-term success, the predictive value of tachycardia during tilt for success with beta- blocker treatment, and the response to treatment within each of the ma jor mechanisms of syncope.