Related Experiment Videos
Responses of normal subjects during 80 degrees head upright tilt table testing with and without low dose
B P Grubb1, D Kosinski, P Temesy-Armos
1Department of Medicine, Medical College of Ohio, Toledo 43699, USA.
Head upright tilt table testing has emerged as a standard technique for the evaluation of patients with recurrent unexplained syncope. To determine the specificity of head upright tilt table testing with and without a low dose isoproterenol infusion, the following study was undertaken. A total of 34 normal volunteers (21 men, 13 women, mean age 32.9 +/- 1.7 years) with no history of syncope, presyncope, or vertigo underwent head upright tilt table testing for 45 minutes. A positive test was defined as the production of syncope or presyncope associated with hypotension and bradycardia. If the test was negative the patient was lowered to the supine position and a low dose isoproterenol infusion started (sufficient to raise the heart rate 20-25% above baseline) and the patient retilted for 20 minutes. Three subjects (8.8%; 95% CI: 2, 26; P = 0.23) developed syncope during the test, two during the baseline tilt, and one during isoproterenol infusion. Interestingly, one of these subjects later had a clinical syncopal episode. We conclude that head up tilt table testing at 80 degrees with or with out low level isoproterenol infusion provides an adequate specificity.
Head upright tilt table testing has emerged as a standard technique for the evaluation of patients with recurrent unexplained syncope. To determine the specificity of head upright tilt table testing with and without a low dose isoproterenol infusion, the following study was undertaken. A total of 34 normal volunteers (21 men, 13 women, mean age 32.9 +/- 1.7 years) with no history of syncope, presyncope, or vertigo underwent head upright tilt table testing for 45 minutes. A positive test was defined as the production of syncope or presyncope associated with hypotension and bradycardia. If the test was negative the patient was lowered to the supine position and a low dose isoproterenol infusion started (sufficient to raise the heart rate 20-25% above baseline) and the patient retilted for 20 minutes. Three subjects (8.8%; 95% CI: 2, 26; P = 0.23) developed syncope during the test, two during the baseline tilt, and one during isoproterenol infusion. Interestingly, one of these subjects later had a clinical syncopal episode. We conclude that head up tilt table testing at 80 degrees with or with out low level isoproterenol infusion provides an adequate specificity.