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Updated: Aug 8, 2026
Quantitative Autonomic Testing
Published on: July 19, 2011
Reproducibility of head-up tilt-table testing in pediatric patients with neurocardiogenic syncope
G A Cohen1, D A Lewis, S Berger
1Department of Pediatrics, Section of Neonatology, Medical College of Wisconsin, 8701 Watertown Plank Road MS# 213A, Milwaukee, WI 53226, USA. gcohen@mcw.edu
Insights
This study confirms the head-up tilt-table test is reproducible for diagnosing neurocardiogenic syncope in adolescents. This reliable diagnostic tool aids in evaluating treatment effectiveness for pediatric syncope.
Area of Science:
- Pediatric Cardiology
- Autonomic Nervous System Disorders
Background:
- Neurocardiogenic syncope is a common cause of recurrent syncope in children and adolescents.
- Accurate diagnosis is crucial for effective management and treatment protocols.
- The head-up tilt-table test is a widely used diagnostic tool, but its reproducibility in pediatric populations requires validation.
Purpose of the Study:
- To assess the reproducibility of a standardized head-up tilt-table test protocol in adolescents diagnosed with neurocardiogenic syncope.
- To determine if the test yields consistent results upon repeated administration in the same patient cohort.
- To establish the reliability of this protocol for future evaluations of treatment efficacy.
Main Methods:
- Adolescents (10-18 years) with neurocardiogenic syncope underwent a 70-degree head-up tilt-table test.
- The test duration was 30 minutes or until a positive response (syncope or presyncope).
- Patients with a positive test were retested using the identical protocol, measuring heart rate, blood pressure, and symptom onset.
Main Results:
- Twenty-two patients were enrolled; 17 had a positive test on the first tilt, and 15 had a positive test on the second tilt.
- No significant differences were observed between the two tilts in baseline or symptomatic heart rate and blood pressure parameters.
- The protocol demonstrated consistent results for hemodynamic and symptomatic responses across repeated tests.
Conclusions:
- The head-up tilt-table test protocol is reproducible in adolescents diagnosed with neurocardiogenic syncope.
- This validated reproducibility supports its use in accurately assessing treatment effectiveness for this condition.
- The findings provide a reliable basis for clinical decision-making in pediatric syncope management.
Abstract:
The aim of this study is to assess the reproducibility of a head-up tilt-table test protocol so it may be used to more accurately evaluate the effectiveness of a treatment protocol. Children between the ages of 10 and 18 years presenting to the cardiology department at Children's Hospital of Wisconsin with a diagnosis of neurocardiogenic syncope were eligible for the study. The patients were tilted to 70 degrees for 30 minutes or until a positive test occurred. Patients with a positive test were retilted using the same protocol. Parameters measured included heart rate, blood pressure, and the presence or absence of syncope or presyncope. Twenty-two patients were enrolled in the study. Seventeen patients had a positive test on first tilt. Fifteen had a positive tilt test on the second tilt. There were no significant differences between the two tilts with regard to mean differences of baseline heart rate, systolic blood pressure, or mean arterial pressure. There were no significant differences between the two tilts with regard to mean differences in time until symptoms, heart rate, systolic blood pressure, or mean arterial blood pressure at time of symptoms. This study shows that the head-up tilt-table test protocol used is reproducible in adolescents with the diagnosis of neurocardiogenic syncope.
