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Serious response during tilt-table test in elderly and its prophylactic management
Yang Han1, Xiao-xia Li, Wei-li Jiang
1First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China. Hanyang1088@hotmail.com
Journal of Zhejiang University. Science. B
|March 9, 2005
Summary
The tilt-table test (TTT) can cause serious adverse events in elderly patients, including cardiac arrest and severe hypotension. Careful patient selection and monitoring are crucial for safe TTT execution.
Area of Science:
- Cardiology
- Geriatrics
- Diagnostic Procedures
Background:
- The tilt-table test (TTT) is a common diagnostic tool.
- Elderly patients may be at higher risk for adverse events during TTT.
Purpose of the Study:
- To evaluate the incidence of serious adverse responses during tilt-table testing (TTT).
- To assess the effectiveness of prophylactic management strategies for these serious responses.
Main Methods:
- Seventy-six elderly patients underwent a 70-degree tilt-table test with isoproterenol provocation.
- Continuous electrocardiogram (ECG) and blood pressure monitoring were employed.
- Patients received normal saline infusions throughout the procedure.
Main Results:
- Fifty-one out of 76 patients (67%) had a positive TTT response.
- Twenty-three patients experienced serious adverse responses, including cardiac arrest (6), severe bradycardia (7), and severe hypotension (10).
- Management involved returning to a supine position, leg elevation, atropine, CPR, and oxygen supplementation, with most patients recovering rapidly.
Conclusions:
- The tilt-table test, while non-invasive, carries a risk of serious adverse events, particularly in the elderly population.
- Careful patient selection, controlled isoproterenol infusion, and close monitoring of vital signs are essential for ensuring patient safety during TTT.