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Updated: Jul 16, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
A new alcohol provocation head up tilt protocol in the patients with alcohol-related syncope
Katsuhiko Tateoka1, Yu-ki Iwasaki, Takuya Ono
1Department of Internal Medicine, Division of Cardiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 1138603, Japan.
Aims:
Drinking alcohol is known to be one of the triggering factors of neurally-mediated syncope. Little is known about the diagnostic utility of the conventional and alcohol provocation head up tilt-test (HUT) in patients with alcohol-related syncope. We investigated the effect of the alcohol provocation HUT.
Methods And Results:
We studied 12 patients (8 males, age 51 +/- 19 years) who had a history of unexplained post-alcohol ingestion syncope. An alcohol provocation protocol HUT (alcohol HUT), in which the protocol required 350 mL of 5% alcohol beer to be drunk over 5 min followed by positioning with the table tilted up for up to 30 min, was performed after the control and isoproterenol (ISP) HUT. None of the subjects (0/12) exhibited a positive response in the control HUT, and only one subject had a positive response (1/12; 8.3%) in the ISP HUT. In the alcohol HUT a positive response (9/12; 75%) increased in the patient group, whereas there were no positive responses in the normal control group.
Conclusion:
In the conventional HUT protocols, including ISP provocation, it was difficult to produce a positive response in the patients with alcohol-related syncope. Alcohol ingestion was a useful diagnostic provocation method in such patients.
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