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Syncope: The Diagnostic Value of Head‐Up Tilt Testing
Author(s) -
ORIBE EMILIO,
CARO SUSANA,
PERERA ROHAN,
WINTERS STEPHEN L.,
GOMES J. ANTHONY,
KAUFMANN HORACIO
Publication year - 1997
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1997.tb05489.x
Subject(s) - medicine , syncope (phonology) , head (geology) , tilt table test , value (mathematics) , tilt (camera) , cardiology , heart rate , structural engineering , blood pressure , engineering , geomorphology , machine learning , computer science , geology
To determine the usefulness of prolonged head‐up tilt in the diagnosis of neurally mediated syncope, 201 patients with history of syncope of unknown cause and 102 age and gender matched control subjects underwent a 40 minute 60 degree head‐up tilt test. Head‐up tilt elicited syncope (i.e., was positive) in 74 of the 201 patients (37%) with a history of unexplained syncope and in only 6 of the 102 controls (6%). The specificity of the test was 100% in patients 60 years of age and older. Symptoms during tilt‐induced syncope were identified by the patients as similar to those they had suffered during their spontaneous episodes. All 80 subjects who had tilt‐induced syncope recovered without sequelae. The positive predictive value of a positive response to head‐up tilt was 93% and the negative predictive value was 43%. The results indicate that the prolonged head‐up tilt test is a very specific procedure of high diagnostic value in patients with a history of unexplained syncope. It is particularly useful in the elderly age groups who have a high incidence of syncope.