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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Application of head-up tilt table testing in children
Wei-Ting Lai1, Ming-Ren Chen, Shan-Miao Lin
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|September 25, 2010
Summary
Head-up tilt table testing (HUT) is safe and effective for diagnosing neurocardiogenic syncope (NCS) in children. While NCS recurrence is common, it is generally self-limiting and less severe with treatment.
Area of Science:
- Pediatric Cardiology
- Autonomic Dysfunction
- Diagnostic Testing
Background:
- Limited pediatric studies on head-up tilt table testing (HUT) for neurocardiogenic syncope (NCS).
- Need for effective diagnostic tools in pediatric syncope evaluation.
Purpose of the Study:
- Investigate the application and safety of HUT in children.
- Evaluate the management of NCS in pediatric patients.
Main Methods:
- Seventy-nine pediatric patients (ages 6-18) underwent HUT.
- Clinical diagnosis of NCS or non-NCS based on triggers and symptoms.
- Hemodynamic responses classified into four types.
Main Results:
- NCS diagnosed in 65 patients; non-NCS in 14.
- Isoproterenol increased HUT sensitivity (28% to 45%) with minor specificity decrease.
- No complications reported; 30.8% recurrence rate, generally less severe.
- Recurrence rates similar across HUT results and treatment types.
Conclusions:
- HUT is safe and specific for pediatric syncope evaluation.
- Isoproterenol enhances HUT sensitivity in children.
- NCS is typically self-limiting in children despite high recurrence.
