Premium
Significance of Tilt Table Testing in Patients with Suspected Arrhythmic Syncope and Negative Electrophysiologic Study
Author(s) -
GARCÍACIVERA ROBERTO,
RUIZGRANELL RICARDO,
MORELLCABEDO SALVADOR,
SANJUANMAÑEZ RAFAEL,
FERRERO ANGEL,
MARTÍNEZBROTONS ANGEL,
ROSELLÓ ARACELI,
BOTELLA SEGISMUNDO,
LLACER ANGEL
Publication year - 2005
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2005.50029.x
Subject(s) - medicine , presyncope , syncope (phonology) , cardiology , tilt table test , implantable loop recorder , etiology , sinus bradycardia , atrioventricular block , sinus rhythm , vasovagal syncope , bradycardia , anesthesia , heart rate , atrial fibrillation , blood pressure
Background: The diagnostic significance of a tilt table test (TTT) in patients with a suspected arrhythmic etiology for syncope and negative electrophysiologic study (EPS) has not been previously assessed comparing the TTT results with the findings of prolonged monitoring using an implantable loop recorder (ILR). We sought to assess the diagnostic yielding of TTT in patients with suspected arrhythmic syncope and negative EPS. Methods and Results: In 81 patients with suspected arrhythmic etiology for syncope and negative EPS, TTT was performed and an ILR implanted regardless the results of TTT. TTT was positive in 38 patients. During follow‐up, syncope or presyncope recurred in 32 patients (39.5%). No differences were found in recurrence rates in patients with positive and negative TTT (31.5% vs 46.5%, P = ns). According to rhythm registered during ILR activation, mechanisms of syncopal events were classified as: arrhythmic (atrioventricular [AV] block and ventricular tachycardia; n = 18), neurally mediated (sinus bradycardia and sinus pause; n = 9), and indeterminate (normal sinus rhythm; n = 5). There was no statistical association between the results of TTT and the mechanism of syncope. Conclusions: In patients with a suspected arrhythmic etiology for syncope and a negative EPS, TTT is of little value to predict the mechanism of syncope and the ILR implantation seems to be a useful and safe diagnostic strategy.