A Practical Approach to Syncope

High Risk Patients who may need admissionand early electrophysiological evaluationThose with possible tachy-arrhythmias• Syncope during exertion or supine• Palpitations during syncope• Frequent VEs or NSVT• Pre-excited QRS complexes• Short or long QT intervals, Brugada pattern ECG• Family Hx of SCDThose with possible brady-arrhythmias• PR prolongation, Bi fascicular block, Intraventricular conduction defects(QRS>120ms)• Sinus bradycardia (< 50bpm) or sinoatrial blockEvidence of Coronary artery Dis, or Severe sructural Ht. Dis.• Hx of MI, Angina• Clinical evidence of Ht. failure or low EF on echo