p.6 抽出テキスト

....................................... Compared with the previous versions of these Guidelines, the 2018 document contains Supplementary Data as an integral part. While the print text mainly aims to give formal evidence-based recommendations according to the standardized rules of the ESC, this new web-only feature allows expansion of the content to practical issues, and aims to fill the gap between the best available scientific evidence and the need for dissemination of these concepts into clinical practice (‘We have the knowledge, we need to teach it’). Thanks to the Supplementary Data further explanation on specific points is given, and thanks to the Web Practical Instructions advice is given on how to evaluate patients with loss of consciousness (LOC), and how to perform and interpret tests properly; whenever possible, we provide tracings, videos, flow charts, and checklists. The document aims to be patient-orientated and focused on therapy, and to reduce the risk of recurrence and the life-threatening consequences of syncope recurrence. For this purpose, even in the absence of strong evidence from trials, we give as much advice as possible on the most appropriate therapy based on the practical expertise of the members of the Task Force (‘Our patients seek solutions, not only explanations’). When possible, we provide therapeutic and decision-making algorithms.

Finally, we recognize that one major challenge in syncope management is the reduction of inappropriate admissions and inappropriate use of tests while maintaining the safety of the patient. We give strong focus to pathways and organizational issues (‘We have the knowledge; we need to apply it’). In particular, we propose a care pathway for the

Figure 1 What is new in the 2018 syncope Guidelines? AA = antiarrhythmic; AF = atrial fibrillation; ARVC = arrhythmogenic right ventricular cardiomyopathy; CSM = carotid sinus massage; ECG = electrocardiogram; ED = emergency department; LVEF = left ventricular ejection fraction; EPS = electrophysiological study; HCM = hypertrophic cardiomyopathy; ICD = implantable cardioverter defibrillator; ILR = implantable loop recorder; OH = orthostatic hypotension; PCM = physical counter-pressure manoeuvres; POTS = postural orthostatic tachycardia syndrome; PPS = psychogenic pseudosyncope; SNRT = sinus node recovery time; SU = syncope unit; SVT = supraventricular tachycardia; VT = ventricular tachycardia. Downloaded from academic.oup.com/eurheartj/article/39/21/1883/4939241 by guest on 07 October 2026