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Tilt table testing for syncope and collapse.

Ritsuko Kohno1, Wayne O Adkisson1, David G Benditt2

  • 1Cardiac Arrhythmia Center, Cardiovascular Division, University of Minnesota, 420 Delaware Street SE, MMC 508, 55455, Minneapolis, MN, USA.

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Summary
This summary is machine-generated.

Head-up tilt (HUT) testing helps diagnose vasovagal syncope (VVS) when patient history is unclear. This safe and effective method reproduces symptoms, confirming the diagnosis and guiding treatment.

Keywords:
BradycardiaCardioinhibitionHeart rateVasodepressorVasovagal

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Area of Science:

  • Cardiology
  • Clinical Physiology

Background:

  • Head-up tilt (HUT) has been utilized to study cardiovascular responses to postural changes.
  • Observations during HUT studies revealed associations between hypotension, bradycardia, and transient loss of consciousness, suggestive of vasovagal syncope (VVS).

Purpose of the Study:

  • To establish HUT as a diagnostic tool for suspected vasovagal syncope (VVS).
  • To evaluate the utility and safety of HUT, with and without pharmacological provocation, in diagnosing VVS.

Main Methods:

  • HUT testing, performed drug-free or with pharmacological agents like nitroglycerin.
  • Careful history taking to supplement HUT findings.

Main Results:

  • HUT testing is a useful and safe modality for identifying susceptibility to VVS.
  • Reproduction of patient symptoms during HUT can confirm a diagnosis of VVS.

Conclusions:

  • While patient history is primary for diagnosing VVS, HUT serves as a valuable tool when history is non-diagnostic.
  • Accurate interpretation of HUT results, correlating with clinical presentation, is crucial for diagnosis and subsequent patient management.