The Italian Model

Some Italian hospitals have specialist units within their cardiology departments, which are managed by cardiologists and run by a team of specialised medical and support staff. These units are referred to as ‘Syncope Units’.1

Once a patient is referred to the Syncope Unit they will have preferential access to all the other facilities in the department and can therefore promptly undergo any investigation considered useful; they may also be admitted to the cardiology ward or intensive care unit, if necessary. When appropriate, other specialists, e.g. neurologists, are involved in patient management and non-cardiological examinations are performed. Patients may be referred from the emergency department, in-patient services or out-patient clinics.

In hospitals with Syncope Units, overall management of syncope has been found to be considerably better compared to those without.2 The number of unnecessary investigations was found to be reduced and the number of tests leading to diagnosis was increased.3


  1. Brignole M, et al. Guidelines on Management (Diagnosis and Treatment) of Syncope โ€“ Update 2004. Europace 2004; 6: 467-537
  2. Brignole M, Disertori M, Menozzi C, et al. The management of syncope referred urgently to general hospitals with and without syncope units. Europace 2003; 5: 293โ€“298
  3. Croci F, Brignole M, Alboni P, et al. The application of a standardized strategy of evaluation in patients with syncope referred to three Syncope Units. Europace 2002; 4: 351-356