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August 30, 2013Pacing and Clinical Electrophysiology

Nitroglycerin-potentiated head-up tilt testing had a lower positivity rate in patients with likely versus established vasovagal syncope (36% vs 65%, P<0.0001), with similar long-term outcomes.

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Why the study?

Does nitroglycerin-potentiated head-up tilt testing have diagnostic and prognostic value in patients with suspected vasovagal syncope?

Population

369 patients with suspected vasovagal syncope, normal electrocardiogram, and no structural heart disease

Design

Cohort

Follow-up

mean 43 ± 27 months

Key result

Nitroglycerin-potentiated head-up tilt testing had a lower positivity rate in patients with likely versus established vasovagal syncope (36% vs 65%, P<0.0001), with similar long-term outcomes.

Authors

NPNunzia Rosa PetixARAttilio Del RossoRFRaffaello Furlan

Discussion

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Member takes

Overview

Low yield in likely vasovagal syncope warrants cautious test interpretation; leaves open prognostic utility in suspected cases.

Study Design

Type

Observational (n=369)

Structured PICO

Does nitroglycerin-potentiated head-up tilt testing have diagnostic and prognostic value in patients with suspected vasovagal syncope?

P
Population
369 patients with suspected vasovagal syncope (VVS), normal electrocardiogram, and no structural heart disease (198 with typical VVS, 171 with atypical/likely VVS)
I
Intervention
Nitroglycerin-potentiated head-up tilt testing (HUT)
O
Outcome
Positivity rate of HUT and rate of adverse events (composite of all-cause mortality, syncope recurrence, and major diagnostic and/or therapeutic procedures) at long-term follow-upcomposite

Main Result

Absolute Event Rate: 65% vs 36%

p-value: p=<0.0001

Nitroglycerin-potentiated head-up tilt testing has a low diagnostic yield in patients with likely vasovagal syncope and does not predict long-term clinical outcomes.

Cite This Study

Petix et al. (2013) conducted an observational in Suspected Vasovagal Syncope (n=369). Nitroglycerin-potentiated head-up tilt testing (HUT) vs. Established vs likely VVS was evaluated on Positivity rate of HUT (p=<0.0001). Nitroglycerin-potentiated head-up tilt testing had a lower positivity rate in patients with likely versus established vasovagal syncope (36% vs 65%, P<0.0001), with similar long-term outcomes.

synapsesocial.com/papers/6a0baa7aa4798427da6dd122https://doi.org/10.1111/pace.12235
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