Open AccessThe yield of head‐up tilt testing is not significantly increased by repeating the baseline test
Author(s) -
Pavri Behzad B.,
Ruskin Jeremy N.,
Brooks Ross
Publication year - 1996
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960190610
Subject(s) - tilt (camera) , medicine , concordance , reproducibility , head tilt , syncope (phonology) , ophthalmology , mechanical engineering , statistics , mathematics , engineering
Background and hypothesis : Head‐up tilt is widely used in evaluating patients with syncope. Data suggest that baseline tilt without isoproterenol is associated with few ≤ 10%) positive results in normals. However, there is considerable day‐today variability in patients with syncope, resulting in low reproducibility. We hypothesized that repeating the baseline tilt would increase the total number of positive responses. Methods : In all, 193 patients with syncope of unknown etiology prospectively underwent serial baseline tilt (Tilt‐1 and Tilt‐2) at 70° for 25 min on two consecutive days. Results : Of 193 patients, 39(20%) had a positive Tilt‐1. Of these, 19 had a positive Tilt‐2, (positive concordance rate: 19/39 = 49%). Of 154 patients with a negative Tilt‐1, 145 had a negative Tilt‐2 (negative concordance rate: 142/151=94%). Only 9 of 154 patients (6%) with a negative Tilt‐1 had a positive Tilt‐2. Thus, the yield increased from 20% (39/193) after Tilt‐1, and to 25% (48/193) after Tilt‐1 plus Tilt‐2, p = NS. Conclusions : (1) Reproducibility of a positive Tilt‐1 is moderate. (2) Reproducibility of a negative Tilt‐1 is high. (3) Repetition of tilt in patients with a negative Tilt‐1 does not significantly increase the number of positive results.