[The tilt-table test in the diagnosis of vasovagal or neurocardiogenic syncope]

Syncope is a common clinical problem, and diagnostic evaluation and treatment of the patient with syncope is often a particularly complex task. As many episodes of unexplained syncope are neurocardiogenic or vasovagal, head-up tilt-table testing is a valuable method for identifying individuals with recurrent loss of consciousness. Although over the past several years much has been learned about pathophysiologic mechanism involved, much of the disorder remains incompletely understood. Optimal standardization of head-up titl-table testing protocols is very important for clinical experience exchanges and for comparison of different therapeutic modalities. Medical therapy is often the first choice and a number of pharmacological treatments have been developed. Exceptionally, has to be combined with dual-chamber cardiac pacing. Head-up tilt-table test is a basic diagnostic procedure in the evaluation of the patient with syncope and should be performed in all cardiac and neurophysiologic laboratories.