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Updated: Jun 14, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Tilt training and pacing: a report on 9 patients with neurally mediated syncope
Tony Reybrouck1, Hein Heidbüchel, Rik Willems
1Department of Cardiology and Cardiovascular Rehabilitation, Gasthuisberg University Hospital Leuven, Belgium. tony.reybrouck@uz.kuleuven.ac.be
Objective:
In patients with neurally mediated syncope (NMS), pacing has been used to prevent bradycardia and syncope. However, recurrence due to the vasodepressor component remains a problem.
Methods:
We report on tilt training in 9 patients with a pacemaker (PM) implantation. Patients were submitted to daily in-hospital tilt testing. They were instructed to continue this therapy at home.
Results:
A negative tilt test was obtained in all patients. Six patients remained free from syncope. Recurrent syncope was observed in 3 patients. In 4 patients the pacemaker had been implanted before the start of the tilt training programme. Five patients had a pacemaker implanted after the administration of tilt training therapy.
Conclusion:
NMS also occurs in paced patients.Tilt training improves the clinical outcome by restoring the vasoconstrictor reserve capacity.
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