THE USEFULNESS OF THE VASIS CLASSIFICATION IN THE EVALUATION OF VASOVAGAL SYNCOPE TYPES

The present methodology in the diagnosis of vasovagal syncope (WS) is based on the clinical evaluation of the course of syncope during the p assive, positive head-up tilt test. The clinical division is based on result analysis of heart rate and blood pressure change during first p assive test and second with vagal nerve inhibition via atropine. Class ification not involving drugs is a division according to the Vasovagal International Study (VASIS). Some research centers, aiming to verify, their diagnosis, employ an evaluation of heart rate variability (HRV) spectrum intensity or a provocative pharmacological test. The goal of our research was to evaluate the type of syncope according to clinica l standards as well as VASIS and verify these results with the help of HRV analysis. The data of 24 patients (pts) aged 15 to 69 yrs (avg. 3 2.8 17.4; 13M, 11F) with clinically diagnosed WS: vasodepressive (VD)- 5, cardioinhibitory (CI)-4, mixed (MX)-15 was analyzed, and in 12 of t hem HRV analysis was possible. In 20 pts (83.3%) the clinically obtain ed syncope type correlated with the VASIS classification. The HRV inte nsity shaped itself as follows: increase of spectrum intensity in the low frequency (LF) and high frequency (HF) range: type VASIS-2 or VASI S-1, decrease in LF and HF: type VASIS-3 or VASIS-1, decrease in LF, i ncrease in HF: type VASIS-1. Conclusion: I)The VASIS classification co rresponds in 83.3% with the standard clinical protocol in differentiat ing syncope types. 2) It defines cardioinhibitory type (2A, 2B) more p recisely, which allows for better evaluation of vessel activity. 3) On the basis of the obtained heterogeneous HRV analysis results, it seem s necessary to broaden the classification of VASIS-1 type into type IA (vasodepressive-like), IB (cardioinhibitory-like) and IC (pure-mixed) .