Introduction: We would like to report the experience and problems of The Syncope Unit in Japan.
Methods: we enrolled consecutive patients referred to our Syncope Clinic for one year.
Results: 54 patients (35 males, age 59) referred due to syncope unknown origins. Their median number of syncope was two. During 30±27 days, 63% of all (34 patients) were diagnosed. The most common origin is reflex syncope (11 panties). Nine patients (17%) rejected further examinations. The others were in process. We performed specialized examination to selected patients as follow: electrophysiological studies for 11 patients (20%), tilt table tests for 15 (27%) and coronary angiography for 9 (17%). Indications of implantable loop recorders were in 11 (20%) for recurrence syncopal episodes at high risk. However, 72 % of them were rejected for the implantations. About treatments, we performed 9 pacemaker implantations, 1 implantable cardioverter-difibrillatior implantation and 2 radiofrequency catheter ablation procedures.
Conclusions: We documented the current practice of syncope management in a specialized facility in Japan. Several major problems were detected. The most common problem is rejections of future managements.