Why the study?
Does the head-up tilt test identify a vasovagal mechanism in patients with syncope of unknown origin and intraventricular conduction defect?
Does the head-up tilt test identify a vasovagal mechanism in patients with syncope of unknown origin and intraventricular conduction defect?
The head-up tilt test is clinically useful for diagnosing vasovagal syncope in patients with unexplained syncope and intraventricular conduction defects, identifying the cause in 25% of cases.
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May support tilt testing to diagnose vasovagal syncope in unexplained cases with conduction defects; hypothesis-generating and requires prospective validation.
Head-up tilt test was performed in 99 patients with syncope of unknown origin and intraventricular conduction defect. Twenty-five per cent had a positive response to tilt with reproduction of spontaneous clinical symptoms. Holter recording revealed paroxysmal atrioventricular (AV) block in three patients. Carotid sinus massage was positive in four patients. An electrophysiological study was performed in 76 patients with abnormal findings in 17 (22%). Thus, vasovagal syncope was the discharge diagnosis in 25 patients (25%). Therefore, tilt test should be considered in patients with intraventricular conduction defect presenting with syncope of unknown origin, especially if clinical findings suggest the possibility of a vasovagal mechanism, or if the results of the electrophysiological study are inconclusive.
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Sagristà-Sauleda et al. (1999) studied this question.
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