Why the study?
Does a longer duration of loss of consciousness (≥47 seconds) during tilt testing correlate with a more severe clinical history and specific tilt testing responses in patients with suspected neurally mediated syncope?
Does a longer duration of loss of consciousness (≥47 seconds) during tilt testing correlate with a more severe clinical history and specific tilt testing responses in patients with suspected neurally mediated syncope?
A longer duration of loss of consciousness during tilt testing is associated with a more severe clinical history of syncope and deeper cerebral hemodynamic disturbances, confirming a vasovagal etiology.
Prolonged dLOC on tilt testing may flag severe vasovagal syncope; hypothesis-generating and requires prospective validation before guiding care.
OBJECTIVE: The authors assessed the relationships between the duration of loss of consciousness (dLOC) during tilt testing-induced syncope (TTS) and demographics, medical history as well as tilt testing results. Previous research focused on the relevance of the type of neurocardiogenic reaction during TTS. The importance of dLOC has not been assessed so far. The study was carried out in 274 patients with suspected neurally mediated syncope and total loss of consciousness during tilt testing. RESULTS: The syncope burden, demographics, and data regarding spontaneous syncope orTTS were compared between group I with dLOC > or =47 seconds and group 2 with dLOC <47 seconds. Medical history revealed that patients in group I had more syncopal spells, more frequent syncope-related traumatic injuries, urine incontinence, jerking movements and typical vasovagal history than in group 2. Moreover, group I patients had more frequently a cardioinhibitory type of reaction and a shorter active phase duration. In addition, they manifested more frequent accompanying cerebral hypoperfusion signs and reproduction of symptoms during TTS than patients in group 2. CONCLUSIONS: The loss of consciousness during tilt testing-induced syncope differs in terms of duration among patients with neurally mediated syncope. The dLOC during TTS is associated with medical history and tilt-testing data which confirm the vasovagal aetiology of spontaneous events. The longer dLOC suggests deeper cerebral haemodynamic disturbances during either spontaneous or provoked syncope.
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Zyśko et al. (2010) studied this question.
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