Reproducibility of asystole during head-up tilt testing in patients with neurally mediated syncope.
Tilt induced prolonged asystole has been considered to identify a distinct subgroup of patients with neurally mediated syncope and management including permanent pacemaker implantation has been suggested. To evaluate the reproducibility of asystolic response during head-up tilt testing (HUT), 33 patients with neurally mediated syncope and asystolic response (> or = 3 seconds) during HUT prospectively underwent two consecutive tests 13 +/- 15 days apart. On repeat tilt testing asystole was reproduced in 12 patients (36%), while 8 patients still had a positive HUT, but without asystole. Remarkably, 13 patients (40%) had a negative repeat HUT. Among 12 patients with asystole on both HUTs there was no significant difference in duration of asystole (14 371 +/- 11 430 ms vs 13 707 +/- 10 470 ms, P = ns) and time to syncope (36 +/- 20 min vs 37 +/- 20 min, P = ns) during initial and repeat HUTs. In conclusion, asystole during tilt testing does not seem to be a reproducible response.
Foglia-Manzillo
G
G
Department of Cardiology, Ospedale Valduce, Como, Italy. cardiologia@valduce.it
Romanò
M
M
Corrado
G
G
Tagliagambe
L M
LM
Tadeo
G
G
Spata
M
M
Spinelli
A
A
Grieco
A
A
Santarone
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006323:Heart Arrest; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D019462:Syncope, Vasovagal / Q000175:diagnosis*; D018667:Tilt-Table Test