The Risk of Thirty-Day Serious Dysrhythmia in Elderly Patients With Syncope or Near Syncope

I read with great interest the article by Nishijima et al.1 This was a large, well-designed, prospective study that demonstrated that 3% of adult patients aged 60 years or older who present to the emergency department (ED) with syncope or near syncope may later incur a serious dysrhythmia that may not be apparent during initial ED evaluation. The primary outcome of serious dysrhythmia was appropriately defined according to current American Heart Association guidelines2 and included symptomatic supraventricular tachycardia, the most common primary outcome observed in this study (42 subjects; 40%).

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