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Circulation. 2017;136:e60–e122. DOI: 10.1161/CIR.0000000000000499 August 1, 2017 e65 CLINICAL STATEMENTS AND GUIDELINES agreed to make Class IIa recommendations because of the paucity of outcome data. The definition of older populations has been evolving. Age >75 years is used to define older populations or older adults in this document, unless otherwise specified. If a study has defined older adults by a different age cutoff, the relevant age is noted in those specific cases. Finally, the guideline addresses the management of syncope with the patient as a focus, rather than larger aspects of health services, such as syncope management units. The goals of the present guideline are: • To define syncope as a symptom, with different causes, in different populations and circumstances. • To provide guidance and recommendations on the evaluation and management of patients with suspected syncope in the context of different clinical settings, specific causes, or selected circumstances. • To identify key areas in which knowledge is lacking, to foster future collaborative research opportunities and efforts. In developing this guideline, the writing committee reviewed the evidence to support recommendations in the relevant ACC/AHA guidelines noted in Table 2 and affirms the ongoing validity of the related recommendations in the context of syncope, thus obviating the need to repeat existing guideline recommendations in Table 2. Relevant ACC/AHA Guidelines Title Organization Publication Year (Reference) ACC/AHA guideline policy relevant to the management of syncope Supraventricular tachycardia ACC/AHA/HRS 201510 Valvular heart disease AHA/ACC 201411 Device-based therapies for cardiac rhythm abnormalities ACCF/AHA/HRS 201212 Ventricular arrhythmias and sudden cardiac death ACC/AHA/ESC 200613* Other ACC/AHA guidelines of interest Hypertension* ACC/AHA – Stable ischemic heart disease ACC/AHA/ACP/AATS/ PCNA/SCAI/STS 2012 and 201414,15 Atrial fibrillation AHA/ACC/HRS 201416 Non–ST-elevation acute coronary syndromes AHA/ACC 201417 Assessment of cardiovascular risk ACC/AHA 201318 Heart failure ACC/AHA 201319* Hypertrophic cardiomyopathy ACC/AHA 201120 Assessment of cardiovascular risk in asymptomatic adults ACC/AHA 201021 Adult congenital heart disease ACC/AHA 200822* Other related references Scientific statement on electrocardiographic early repolarization AHA 201623 Expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope HRS 201524 Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death ESC 2015 and 201325,26 Expert consensus statement on the recognition and management of arrhythmias in adult congenital heart disease PACES/HRS 201427 Expert consensus statement on the use of implantable cardioverter-defibrillator therapy in patients who are not included or not well represented in clinical trials HRS/ACC/AHA 201428 Expert consensus statement on ventricular arrhythmias EHRA/HRS/APHRS 201429 Expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes HRS/EHRA/APHRS 201325 Guidelines for the diagnosis and management of syncope ESC 200930 *Revisions to the current documents are being prepared, with publication expected in 2017. AATS indicates American Association for Thoracic Surgeons; ACC, American College of Cardiology; ACCF, American College of Cardiology Foundation; ACP, American College of Physicians; AHA, American Heart Association; APHRS, Asia Pacific Heart Rhythm Society; EHRA, European Heart Rhythm Association; ESC, European Society of Cardiology; HRS, Heart Rhythm Society; PACES, Pediatric and Congenital Electrophysiology Society; PCNA, Preventive Cardiovascular Nurses Association; SCAI, Society for Cardiovascular Angiography and Interventions; and STS, Society of Thoracic Surgery. Downloaded from http://ahajournals.org by on October 7, 2026