A new alcohol provocation head up tilt protocol in the patients with alcohol-related syncope.
OBJECTIVE
Drinking alcohol is known to be one of the triggering factors of neurally-mediated syncope. Little is known about the diagnostic utility of the conventional and alcohol provocation head up tilt-test (HUT) in patients with alcohol-related syncope. We investigated the effect of the alcohol provocation HUT.


RESULTS
We studied 12 patients (8 males, age 51 +/- 19 years) who had a history of unexplained post-alcohol ingestion syncope. An alcohol provocation protocol HUT (alcohol HUT), in which the protocol required 350 mL of 5% alcohol beer to be drunk over 5 min followed by positioning with the table tilted up for up to 30 min, was performed after the control and isoproterenol (ISP) HUT. None of the subjects (0/12) exhibited a positive response in the control HUT, and only one subject had a positive response (1/12; 8.3%) in the ISP HUT. In the alcohol HUT a positive response (9/12; 75%) increased in the patient group, whereas there were no positive responses in the normal control group.


CONCLUSIONS
In the conventional HUT protocols, including ISP provocation, it was difficult to produce a positive response in the patients with alcohol-related syncope. Alcohol ingestion was a useful diagnostic provocation method in such patients.
Tateoka
Katsuhiko
K
Department of Internal Medicine, Division of Cardiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 1138603, Japan.
Iwasaki
Yu-ki
YK
Ono
Takuya
T
Kobayashi
Yoshinori
Y
Katoh
Takao
T
Takano
Teruo
T
D000428:Alcohol Drinking / Q000009:adverse effects*; D000431:Ethanol; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013575:Syncope / Q000139:chemically induced* / Q000175:diagnosis*; D018667:Tilt-Table Test / Q000379:methods*
D000431:Ethanol