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[The tilt-table test in assessing syncope of unknown origin: do differences exist between children and adults?]
L Tercedor1, J F Díaz, M J Aguado
1Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada.
Background And Objectives:
Little is known about the differences between children and adults in the results of head-up tilt test. This study sought to investigate the potential differences concerning: a) the clinical profile and circumstances of spontaneous syncope; b) the overall diagnostic performance of the test, and c) the type of positive response obtained.
Material And Methods:
We studied 31 children and 123 adults with unexplained syncope. If baseline test (tilting at 70 degrees for 30 min) resulted negative, it was repeated under isoprenaline low-dose infusion.
Results:
There were no differences in either clinical profile, except for severe traumatism more frequent in adults (25% vs. 3% in children; p < 0.05), or overall diagnostic performance (39% in children vs. 33% in adults; p = NS). However, the way the test rendered positive (via basal tilting in 92% of children vs. 50% in adults; p < 0.05) and the rate of cardioinhibitory response (42% in children vs 8% in adults; p < 0.01) were significantly different.
Conclusions:
In this study children, in contrast to adults, rarely have a positive response in tilting under isoprenaline infusion. They also present a much higher rate of cardio-inhibitory response than adults.