Head-upright tilt table testing. A safe and easy way to assess neurocardiogenic syncope

Head-upright tilt table testing has emerged as an exciting technique for evaluating episodes of autonomically mediated syncope. It may be performed using gravity alone as the provocative stimulus or with the addition of isoproterenol. The classic neurocardiogenic response to the test is a sudden drop in blood pressure followed by a decrease in heart rate, but other abnormal response patterns have also been reported. Continuing investigations will improve understanding of autonomic disturbances that cause orthostatic intolerance and will help elaborate the role of tilt table testing in their evaluation and management.