Sequential head-up tilt testing in patients with recent syncope showed decreasing reproducibility of a positive response, dropping from 80% at 1 week to 53% at 2 weeks (P<0.01).
RCT (n=127)
Randomized
What is the reproducibility of sequential head-up tilt testing in patients with recent syncope, normal ECG, and no structural heart disease?
The reproducibility of a positive head-up tilt test decreases over time and shows significant intra-individual variation, whereas a negative response has high reproducibility.
Absolute Event Rate: 80% vs 53%
p-value: p=<0.01
AIMS: To assess the reproducibility of the response to sequential head-up tilt tests. METHODS AND RESULTS: A head-up tilt test was performed early after syncope in 127 patients with a normal ECG and no structural heart disease. Patients with a positive response (82 patients) were randomized to two (1 week and 2 weeks later) or one (2 weeks later) additional head-up tilt tests, and patients with a negative response (45 patients) were randomized to a second head-up tilt test 1 or 2 weeks after the first. The reproducibility of a positive response in the second head-up tilt test was 80% after 1 week and 53% after 2 weeks (P<0.01). Only 53% of the patients with a positive response to a first and second head-up tilt test had a positive response to a third (P=0.01). Intra-individual variation in the time to a positive response was wide. The reproducibility of the cardioinhibitory responses was very poor. Reproducibility of a negative response was 80%. CONCLUSIONS: In patients with recent syncope, the rate of positive responses decreases with sequential head-up tilt tests. Furthermore, the time to a positive response in different head-up tilt tests shows important intra-individual variations, and the reproducibility of the cardioinhibitory responses is very poor. In contrast, the reproducibility of the negative responses is high.
Jaume Sagristà-Sauleda (Mon,) conducted a rct in Recent syncope (n=127). Sequential head-up tilt testing at 1 week vs. Sequential head-up tilt testing at 2 weeks was evaluated on Reproducibility of a positive response in the second head-up tilt test (p=<0.01). Sequential head-up tilt testing in patients with recent syncope showed decreasing reproducibility of a positive response, dropping from 80% at 1 week to 53% at 2 weeks (P<0.01).