Role of tilt-table testing in syncope diagnosis and management: analysis of patients referred to a syncope unit Article Swipe
A Castelo
,
Sérgio Laranjo
,
Ana Lousinha
,
Pedro Silva Cunha
,
Carlos Manuel de Almeida Brandão
,
Sandra Alves
,
Anderson Soares da Silva
,
V Ferreira
,
P Garcia Bras
,
T Mano
,
Mário Oliveira
,
Filipa Ferreira
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1093/ehjci/ehaa946.0710
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1093/ehjci/ehaa946.0710
Introduction Head-up tilt-testing (HUT) enables the reproduction of reflex syncope in a laboratory setting. Despite being used to confirm the diagnosis of this syncope, there is some concerns regarding the best protocol to use and recent studies with implantable loop recorders have called the value of HUT into question. Aim To characterize the population undergoing HUT according to the modified Italian protocol, type of response to HUT and subsequent management at our center in the last 4 years. Methods Retrospective analysis of consecutive P who underwent HUT between 2015 and 2018. Descriptive analysis of patients (P) demographics and medical history, indication for HUT, type of response to HUT and management. Results A total of 419P (55.1% female) were included with a mean age of 62 years. The majority (n=302, 72.1%) had comorbidities (structural heart disease – 55%, cardiac dysrhythmias – 57.6%, hypertension – 48.3%, diabetes – 15.6%, depression – 15.9%, cerebrovascular disease –10.6%) or was under medication (n=220, 52.5%) with a potential hypotensive or bradycardic effect (44.1% ACEI/ARA, 29.1% beta-blocker, 27.7% diuretic, 23.6% antidepressant, 22.7% calcium channel blocker, 19.1% benzodiazepines). Syncope/presyncope episodes accounted for 56.1% of the HUT, with falls and disequilibrium accounting for 52%. In 21 cases (5%) suspected dysautonomia or other non-specified reasons were the indication for HUT. HUT were ordered according to the guidelines in 136P (84.6% – indication level I, 3.6% – level IIa, 11.8% – level IIb). HUT was positive in 292P (69.7%) – 77.1% after nitroglycerin administration (vasodepressor – 170P, cardioinhibitory – 53P, mixed – 62P and dysautonomic – 7P). Cardioinhibitory (CI) response predominated in the younger, and vasodepressor in the older P. Of the P with CI response, 41.5% had asystole (median of 41.4s, minimum 7.5s, maximum 115s). All P were instructed in the need to avoid triggering factors and perform counterpressure maneuvers. A pacemaker was implanted in 24P (5.7% of all population, due to long sinus pauses and asystole). Twenty-four P (5.7%) completed a tilt training program. Conclusion Most of the HUT were requested for syncope/presyncope, frequently according to the guidelines. There was a high rate of positive tests, with a predominance of vasodepressive response, particularly in the elderly. Funding Acknowledgement Type of funding source: None
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ehjci/ehaa946.0710
- https://academic.oup.com/eurheartj/article-pdf/41/Supplement_2/ehaa946.0710/34521081/ehaa946.0710.pdf
- OA Status
- bronze
- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3109891131
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3109891131Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/ehjci/ehaa946.0710Digital Object Identifier
- Title
-
Role of tilt-table testing in syncope diagnosis and management: analysis of patients referred to a syncope unitWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2020Year of publication
- Publication date
-
2020-11-01Full publication date if available
- Authors
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A Castelo, Sérgio Laranjo, Ana Lousinha, Pedro Silva Cunha, Carlos Manuel de Almeida Brandão, Sandra Alves, Anderson Soares da Silva, V Ferreira, P Garcia Bras, T Mano, Mário Oliveira, Filipa FerreiraList of authors in order
- Landing page
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https://doi.org/10.1093/ehjci/ehaa946.0710Publisher landing page
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https://academic.oup.com/eurheartj/article-pdf/41/Supplement_2/ehaa946.0710/34521081/ehaa946.0710.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/eurheartj/article-pdf/41/Supplement_2/ehaa946.0710/34521081/ehaa946.0710.pdfDirect OA link when available
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Medicine, Presyncope, Syncope (phonology), Tilt table test, Population, Vasovagal syncope, Internal medicine, Cardiology, Pediatrics, Anesthesia, Emergency medicine, Heart rate, Blood pressure, Environmental healthTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1Per-year citation counts (last 5 years)
- Related works (count)
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10Other works algorithmically related by OpenAlex
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