Tilt Table Test Usefulness for the Identification of Patients with Vasovagal Syncope

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Abstract

Background Syncope isa frequent medical problem caused by a wide variety of diseases with different prognostic. The ethiologic diagnosis is not always possible. We studied the usefulness of the tilt test for the evaluation of vasovagal syncope. Method The tilt table test was performed in one hundred two symptomatic patients. Fifty were females and fifty two were males (mean age 41.5 years), 76 with syncope (groupA),26 with presyncope (group B)of unknown origin and in nine control subjects. The symptoms were recurrent in 67 (65,6%). Results The upright tilt-table test was positive in 69 (68%). Eighty percent in group A and 30% in group B (p = 0.000012) had a positive response. Patients with recurrent symptoms had a positive test in 78% of cases and 49% in non recurrent (p=0.005); 51 of 69 patients were positives with isoproterenol. Response was vasovagal in 19, cardioinhibitory in 5, and both in 45 patients, 24 developed syncope and 45 presyncope. The most frequent rhythm abnormality was sinus bradycardia, and 4 patients developed asystole (maximum of 6.8 seconds). None of the controls had a positive test. Conclusions The tilt-table test is clinically useful in the diagnosis of vasovagal syncope, especially in patients with recurrent symptoms.