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Updated: Sep 6, 2025

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

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Risk Factors and Prognostic Follow-Up of Vasovagal Syncope Children With Seizure-Like Activities During Head-Up Tilt

Runmei Zou1, Shuo Wang2, Wen Wen1,3

  • 1Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China.

Frontiers in Cardiovascular Medicine
|June 27, 2022
PubMed

Insights

Seizure-like activities during head up tilt test (HUTT)-induced syncope in children with vasovagal syncope (VVS) are linked to asystole and specific response types. These children, however, show a good prognosis without long-term negative outcomes.

Area of Science:

  • Pediatrics
  • Cardiology
  • Neurology

Background:

  • Vasovagal syncope (VVS) is common in children and can present with complex symptoms during diagnostic testing.
  • Head up tilt test (HUTT) is a key diagnostic tool for VVS, sometimes eliciting seizure-like activities.
  • Understanding risk factors for these activities is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To identify risk factors for seizure-like activities during HUTT-induced syncope in children with VVS.
  • To evaluate the prognosis of VVS patients who experience seizure-like activities during HUTT.

Main Methods:

  • Retrospective analysis of VVS children undergoing HUTT, categorized into convulsive and non-convulsive groups.
  • Review of clinical characteristics, hemodynamic parameters during HUTT, and follow-up data.
  • Logistic regression analysis to determine independent risk factors.

Main Results:

  • Asystole and cardioinhibitory or mixed response types were significant risk factors for seizure-like activities during HUTT.
  • Patients with asystole had a 37.18-fold increased risk; cardioinhibitory/mixed types had 308.25/6.08-fold increased risks, respectively.
  • No significant differences in HUTT conversion or re-syncope rates were observed between groups at follow-up.

Conclusions:

  • Asystole and specific autonomic response types (cardioinhibitory, mixed) are independent predictors of seizure-like activities in pediatric VVS.
  • Close monitoring is warranted for VVS patients with asystole and these response types during HUTT.
  • Seizure-like activities during HUTT do not indicate a poorer long-term prognosis for children with VVS.
Abstract

Keywords:
childrenfollow-uphead-up tilt testrisk factorseizure-like activitiesvasovagal syncope

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