Reproducibility of head upright tilt table test results in patients with syncope.
Head upright tilt table testing is a promising technique for the evaluation and management of vasovagal (neuroregulatory) syncope. In order to determine the day-to-day reproducibility of results using this technique we performed head upright tilt table testing (with or without graded isoproterenol infusion) in 21 patients (12 males, 9 females, mean age 34 +/- 19.1 years). During the first tilt study a total of 14 patients experienced syncope (six during baseline tilt, mean tilt time 15.8 +/- 7 minutes, eight following tilt with graded isoproterenol infusion, mean tilt time 17.7 +/- 9 minutes) while seven were negative. During the second tilt study (performed 3-7 days following the first study) the results of the first study were duplicated in 19 patients (90%) (six during baseline tilt, mean time 17.5 +/- 8 minutes, eight following graded isoproterenol infusion, mean time 15.9 +/- 7 minutes), however the level of provocation required to provoke syncope differed from that needed in the initial test in five patients (24%). We conclude that the results of head upright tilt table testing with graded isoproterenol infusions can be duplicated in 90% of patients, although some day-to-day variability exists in the degree of provocation necessary to elicit a positive response.
Grubb
B P
BP
Department of Medicine, Medical College of Ohio, Toledo 43699.
Wolfe
D
D
Temesy-Armos
P
P
Hahn
H
H
Elliott
L
L
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D001919:Bradycardia / Q000209:etiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology; D007545:Isoproterenol; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D011187:Posture / Q000502:physiology*; D015203:Reproducibility of Results; D013575:Syncope / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D014630:Vagus Nerve / Q000503:physiopathology*
D007545:Isoproterenol