[Tilt testing in the diagnosis and treatment of syncope]

Neurocardiogenic syncope is an entity with significant prevalence and incidence. Although with low mortality, it has negative implications in the quality of life of these patients. Today, there are international guidelines for the diagnosis of syncope, and tilt testing has been accepted as a useful diagnostic test, particularly in recurrent syncope of unknown etiology. Several protocols have been described in the last years, first including a passive phase only and later with the introduction of provocative agents, from which sub-lingual nitrates are the most widely accepted due to the simplified protocol and good results. The use of tilt testing in the evaluation of the treatment results is limited due to problems related with it's reproducibility, that are however the base for a treatment option recently available--tilt training--however with variable success rates. In this review, we will talk about clinical practice aspects related with tilt testing.