Key result
Tilt-table testing yielded a positive result in a high proportion of elderly patients with unexplained syncope, including 37% of those aged ≥65 years and 23% of those aged ≥80 years.
Why the study?
Does age affect the positivity rate of tilt-table testing in patients with unexplained syncope?
Observational (n=352)
Does age affect the positivity rate of tilt-table testing in patients with unexplained syncope?
Tilt-table testing remains a useful diagnostic tool for unexplained syncope in elderly patients, despite an age-related decline in positivity rates.
Answers are grounded in this paper and cite their sources.
Supports tilt-table testing utility in elderly syncope; leaves open age-specific yield and prospective validation needs.
Although neurally mediated syncope is thought to be common in the young and rare in the elderly, there are few data evaluating the effects of age on the outcome of tilt-table testing (TTT), especially in patients aged > or =80 years. We examined the results of TTT in 352 subjects with unexplained syncope including 133 patients >65 years of age and 43 patients >80 years of age. The average age was 54 +/- 20.8 years (range 11 to 99) and 51% were men. The TTT protocol included at least 45 minutes of upright tilt in the drug-free state with or without repeat TTT with isoproterenol or 15 minutes of upright tilt in the drug-free state followed by repeat TTT with isoproterenol. One hundred sixty-four subjects (47%) had a positive TTT. As expected, there was an age-related decline in positive TTT. A high proportion of elderly patients with unexplained syncope had a positive TTT (37% of patients aged > or =65, and 23% patients aged > or =80). Thus, TTT is a useful diagnostic test in patients aged > or =65 years with unexplained syncope.
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Bloomfield et al. (1999) conducted an observational in unexplained syncope (n=352). Tilt-table testing (TTT) was evaluated on Positive tilt-table test. Tilt-table testing yielded a positive result in a high proportion of elderly patients with unexplained syncope, including 37% of those aged ≥65 years and 23% of those aged ≥80 years.
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