Tilt table testing for assessing syncope

“Evidence shows that HUT has a low positivity rate in unselected patients with syncope but very acceptable sensitivity (>80%) and specificity (≈90%) in vasovagal syncope. The FAST study showed hospital physicians achieved a diagnostic yield of 63%; a subsequent review from the same group reported the diagnostic yield rises from 60–70% by experienced physicians following guidelines to 85% in syncope units where tilt testing and expert interpretation are available.”

“We submit that the TTT fails to establish an explicit cause of syncope, is plagued by false positives, and never plays a role in guiding treatment. Given these limitations, we believe that TTT should stop being administered for these purposes.”