Diagnostic Assessment of Recurrent Syncope
Identifieur interne : 000C08 ( Main/Corpus ); précédent : 000C07; suivant : 000C09Diagnostic Assessment of Recurrent Syncope
Auteurs : Arjun D. Sharma ; George J. Klein ; Simon MilsteinSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1984-07.
English descriptors
Abstract
The definitive diagnosis of a cardiac arrhythmia as the basis for syncope is made by electrocardiographic monitoring during a syncopal episode. In the absence of this evidence, abnormalities demonstrated by an electrophysiologic study may suggest the etiology of syncope. Cardiac electrophysiologic testing in patients with recurrent syncope should probably be limited to patients with underlying cardiac disease. These patients are at a higher risk for sudden death and have a high incidence of electrophysiologic abnormalities. In particular, ventricular tachycardia may be evoked and specific therapy for this abnormality is associated with remission of syncope. In contrast, electrophysiologic studies in patients with no underlying cardiac disease have a very low yield of abnormal findings in the order of 10–20%, and should be performed only when there are reasons to suspect the presence of arrhythmias. Furthermore, in patients with no underlying cardiovascular disease there is a high spontaneous remission rate of syncope and the late incidence of sudden death is low, and related to the presence of other systemic illnesses. At present, the significance of nonsustained ventricular tachycardia or ventricular fibrillation induced during cardiac electrophysiologic studies in patients with no documented arrhythmias is unknown, and further prospective studies are necessary to define appropriate therapy for these patients. Further investigation is also required to clarify the spontaneous remission rate of syncope, as this information is of vital importance in assessing the success of any therapeutic modality.
Url:
DOI: 10.1111/j.1540-8159.1984.tb05605.x
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ISTEX:D830E51D2BD7EEC6482FFA3038A8F4BED5E6263ELe document en format XML
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Klein</name><affiliation><mods:affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Milstein, Simon" sort="Milstein, Simon" uniqKey="Milstein S" first="Simon" last="Milstein">Simon Milstein</name><affiliation><mods:affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:D830E51D2BD7EEC6482FFA3038A8F4BED5E6263E</idno><date when="1984" year="1984">1984</date><idno type="doi">10.1111/j.1540-8159.1984.tb05605.x</idno><idno type="url">https://api.istex.fr/document/D830E51D2BD7EEC6482FFA3038A8F4BED5E6263E/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000C08</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Diagnostic Assessment of Recurrent Syncope</title><author><name sortKey="Sharma, Arjun D" sort="Sharma, Arjun D" uniqKey="Sharma A" first="Arjun D." last="Sharma">Arjun D. 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Klein</name><affiliation><mods:affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Milstein, Simon" sort="Milstein, Simon" uniqKey="Milstein S" first="Simon" last="Milstein">Simon Milstein</name><affiliation><mods:affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1984-07">1984-07</date><biblScope unit="volume">7</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="749">749</biblScope><biblScope unit="page" to="759">759</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">D830E51D2BD7EEC6482FFA3038A8F4BED5E6263E</idno><idno type="DOI">10.1111/j.1540-8159.1984.tb05605.x</idno><idno type="ArticleID">PACE749</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>cardiac arrhythmias</term><term>electrophysiologic testing</term><term>syncope</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The definitive diagnosis of a cardiac arrhythmia as the basis for syncope is made by electrocardiographic monitoring during a syncopal episode. In the absence of this evidence, abnormalities demonstrated by an electrophysiologic study may suggest the etiology of syncope. Cardiac electrophysiologic testing in patients with recurrent syncope should probably be limited to patients with underlying cardiac disease. These patients are at a higher risk for sudden death and have a high incidence of electrophysiologic abnormalities. In particular, ventricular tachycardia may be evoked and specific therapy for this abnormality is associated with remission of syncope. In contrast, electrophysiologic studies in patients with no underlying cardiac disease have a very low yield of abnormal findings in the order of 10–20%, and should be performed only when there are reasons to suspect the presence of arrhythmias. Furthermore, in patients with no underlying cardiovascular disease there is a high spontaneous remission rate of syncope and the late incidence of sudden death is low, and related to the presence of other systemic illnesses. At present, the significance of nonsustained ventricular tachycardia or ventricular fibrillation induced during cardiac electrophysiologic studies in patients with no documented arrhythmias is unknown, and further prospective studies are necessary to define appropriate therapy for these patients. Further investigation is also required to clarify the spontaneous remission rate of syncope, as this information is of vital importance in assessing the success of any therapeutic modality.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>ARJUN D. SHARMA</name><affiliations><json:string>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</json:string></affiliations></json:item><json:item><name>GEORGE J. KLEIN</name><affiliations><json:string>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</json:string></affiliations></json:item><json:item><name>SIMON MILSTEIN</name><affiliations><json:string>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>cardiac arrhythmias</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>syncope</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>electrophysiologic testing</value></json:item></subject><articleId><json:string>PACE749</json:string></articleId><language><json:string>eng</json:string></language><abstract>The definitive diagnosis of a cardiac arrhythmia as the basis for syncope is made by electrocardiographic monitoring during a syncopal episode. In the absence of this evidence, abnormalities demonstrated by an electrophysiologic study may suggest the etiology of syncope. Cardiac electrophysiologic testing in patients with recurrent syncope should probably be limited to patients with underlying cardiac disease. These patients are at a higher risk for sudden death and have a high incidence of electrophysiologic abnormalities. In particular, ventricular tachycardia may be evoked and specific therapy for this abnormality is associated with remission of syncope. In contrast, electrophysiologic studies in patients with no underlying cardiac disease have a very low yield of abnormal findings in the order of 10–20%, and should be performed only when there are reasons to suspect the presence of arrhythmias. Furthermore, in patients with no underlying cardiovascular disease there is a high spontaneous remission rate of syncope and the late incidence of sudden death is low, and related to the presence of other systemic illnesses. At present, the significance of nonsustained ventricular tachycardia or ventricular fibrillation induced during cardiac electrophysiologic studies in patients with no documented arrhythmias is unknown, and further prospective studies are necessary to define appropriate therapy for these patients. 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Sharma, Cardiac Investigation Unit, University Hospital, Box 5339, Terminal A, London, Ontario, Canada N6A 5A5.</p></note><affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</affiliation></author><author><persName><forename type="first">GEORGE J.</forename><surname>KLEIN</surname></persName><affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</affiliation></author><author><persName><forename type="first">SIMON</forename><surname>MILSTEIN</surname></persName><affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</affiliation></author></analytic><monogr><title level="j">Pacing and Clinical Electrophysiology</title><idno type="pISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><idno type="DOI">10.1111/(ISSN)1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1984-07"></date><biblScope unit="volume">7</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="749">749</biblScope><biblScope unit="page" to="759">759</biblScope></imprint></monogr><idno type="istex">D830E51D2BD7EEC6482FFA3038A8F4BED5E6263E</idno><idno type="DOI">10.1111/j.1540-8159.1984.tb05605.x</idno><idno type="ArticleID">PACE749</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1984</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The definitive diagnosis of a cardiac arrhythmia as the basis for syncope is made by electrocardiographic monitoring during a syncopal episode. In the absence of this evidence, abnormalities demonstrated by an electrophysiologic study may suggest the etiology of syncope. Cardiac electrophysiologic testing in patients with recurrent syncope should probably be limited to patients with underlying cardiac disease. These patients are at a higher risk for sudden death and have a high incidence of electrophysiologic abnormalities. In particular, ventricular tachycardia may be evoked and specific therapy for this abnormality is associated with remission of syncope. In contrast, electrophysiologic studies in patients with no underlying cardiac disease have a very low yield of abnormal findings in the order of 10–20%, and should be performed only when there are reasons to suspect the presence of arrhythmias. Furthermore, in patients with no underlying cardiovascular disease there is a high spontaneous remission rate of syncope and the late incidence of sudden death is low, and related to the presence of other systemic illnesses. At present, the significance of nonsustained ventricular tachycardia or ventricular fibrillation induced during cardiac electrophysiologic studies in patients with no documented arrhythmias is unknown, and further prospective studies are necessary to define appropriate therapy for these patients. Further investigation is also required to clarify the spontaneous remission rate of syncope, as this information is of vital importance in assessing the success of any therapeutic modality.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>cardiac arrhythmias</term></item><item><term>syncope</term></item><item><term>electrophysiologic testing</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1984-07">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/D830E51D2BD7EEC6482FFA3038A8F4BED5E6263E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8159</doi><issn type="print">0147-8389</issn><issn type="electronic">1540-8159</issn><idGroup><id type="product" value="PACE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="PACING CLINICAL ELECTROPHYSIOLOGY">Pacing and Clinical Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="07004"><doi origin="wiley">10.1111/pace.1984.7.issue-4</doi><numberingGroup><numbering type="journalVolume" number="7">7</numbering><numbering type="journalIssue" number="4">4</numbering></numberingGroup><coverDate startDate="1984-07">July 1984</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0074900" status="forIssue"><doi origin="wiley">10.1111/j.1540-8159.1984.tb05605.x</doi><idGroup><id type="unit" value="PACE749"></id></idGroup><countGroup><count type="pageTotal" number="11"></count></countGroup><titleGroup><title type="tocHeading1">THE PRESENT STATUS OF CLINICAL ELECTROPHYSIOLOGIC STUDIES</title></titleGroup><eventGroup><event type="firstOnline" date="2006-06-30"></event><event type="publishedOnlineFinalForm" date="2006-06-30"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:HeaderRef result:HeaderRef" date="2010-03-02"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-03"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="749">749</numbering><numbering type="pageLast" number="759">759</numbering></numberingGroup><correspondenceTo>Address for reprints: Dr. A.D. Sharma, Cardiac Investigation Unit, University Hospital, Box 5339, Terminal A, London, Ontario, Canada N6A 5A5.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PACE.PACE749.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received January 17, 1984; accepted February 14, 1984.</unparsedEditorialHistory><countGroup><count type="referenceTotal" number="58"></count><count type="linksCrossRef" number="4"></count></countGroup><titleGroup><title type="main">Diagnostic Assessment of Recurrent Syncope</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>ARJUN D.</givenNames><familyName>SHARMA</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>GEORGE J.</givenNames><familyName>KLEIN</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>SIMON</givenNames><familyName>MILSTEIN</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="CA"><unparsedAffiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">cardiac arrhythmias</keyword><keyword xml:id="k2">syncope</keyword><keyword xml:id="k3">electrophysiologic testing</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>The definitive diagnosis of a cardiac arrhythmia as the basis for syncope is made by electrocardiographic monitoring during a syncopal episode. In the absence of this evidence, abnormalities demonstrated by an electrophysiologic study may suggest the etiology of syncope. Cardiac electrophysiologic testing in patients with recurrent syncope should probably be limited to patients with underlying cardiac disease. These patients are at a higher risk for sudden death and have a high incidence of electrophysiologic abnormalities. In particular, ventricular tachycardia may be evoked and specific therapy for this abnormality is associated with remission of syncope. In contrast, electrophysiologic studies in patients with no underlying cardiac disease have a very low yield of abnormal findings in the order of 10–20%, and should be performed only when there are reasons to suspect the presence of arrhythmias. Furthermore, in patients with no underlying cardiovascular disease there is a high spontaneous remission rate of syncope and the late incidence of sudden death is low, and related to the presence of other systemic illnesses. At present, the significance of nonsustained ventricular tachycardia or ventricular fibrillation induced during cardiac electrophysiologic studies in patients with no documented arrhythmias is unknown, and further prospective studies are necessary to define appropriate therapy for these patients. Further investigation is also required to clarify the spontaneous remission rate of syncope, as this information is of vital importance in assessing the success of any therapeutic modality.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="n-fnt-1" numbered="no"><p>Research from the authors' laboratory supported by the Ontario Heart Foundation and Medical Research Council of Canada. Dr. Sharma is supported by an Ontario Career Scientist Award. Dr. Klein is a senior research Fellow of the Ontario Heart Foundation. Dr. Milstein is a Cardiology Fellow.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Diagnostic Assessment of Recurrent Syncope</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Diagnostic Assessment of Recurrent Syncope</title></titleInfo><name type="personal"><namePart type="given">ARJUN D.</namePart><namePart type="family">SHARMA</namePart><affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</affiliation><description>Correspondence: Address for reprints: Dr. A.D. Sharma, Cardiac Investigation Unit, University Hospital, Box 5339, Terminal A, London, Ontario, Canada N6A 5A5.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">GEORGE J.</namePart><namePart type="family">KLEIN</namePart><affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">SIMON</namePart><namePart type="family">MILSTEIN</namePart><affiliation>Cardiac Electrophysiology Laboratory, Department of Medicine, University Hospital, London, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1984-07</dateIssued><edition>Received January 17, 1984; accepted February 14, 1984.</edition><copyrightDate encoding="w3cdtf">1984</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">58</extent></physicalDescription><abstract lang="en">The definitive diagnosis of a cardiac arrhythmia as the basis for syncope is made by electrocardiographic monitoring during a syncopal episode. In the absence of this evidence, abnormalities demonstrated by an electrophysiologic study may suggest the etiology of syncope. Cardiac electrophysiologic testing in patients with recurrent syncope should probably be limited to patients with underlying cardiac disease. These patients are at a higher risk for sudden death and have a high incidence of electrophysiologic abnormalities. In particular, ventricular tachycardia may be evoked and specific therapy for this abnormality is associated with remission of syncope. In contrast, electrophysiologic studies in patients with no underlying cardiac disease have a very low yield of abnormal findings in the order of 10–20%, and should be performed only when there are reasons to suspect the presence of arrhythmias. Furthermore, in patients with no underlying cardiovascular disease there is a high spontaneous remission rate of syncope and the late incidence of sudden death is low, and related to the presence of other systemic illnesses. At present, the significance of nonsustained ventricular tachycardia or ventricular fibrillation induced during cardiac electrophysiologic studies in patients with no documented arrhythmias is unknown, and further prospective studies are necessary to define appropriate therapy for these patients. Further investigation is also required to clarify the spontaneous remission rate of syncope, as this information is of vital importance in assessing the success of any therapeutic modality.</abstract><subject lang="en"><genre>Keywords</genre><topic>cardiac arrhythmias</topic><topic>syncope</topic><topic>electrophysiologic testing</topic></subject><relatedItem type="host"><titleInfo><title>Pacing and Clinical Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0147-8389</identifier><identifier type="eISSN">1540-8159</identifier><identifier type="DOI">10.1111/(ISSN)1540-8159</identifier><identifier type="PublisherID">PACE</identifier><part><date>1984</date><detail type="volume"><caption>vol.</caption><number>7</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>749</start><end>759</end><total>11</total></extent></part></relatedItem><identifier type="istex">D830E51D2BD7EEC6482FFA3038A8F4BED5E6263E</identifier><identifier type="DOI">10.1111/j.1540-8159.1984.tb05605.x</identifier><identifier type="ArticleID">PACE749</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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