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tilt table testing
Indications:
- evaluation of neurocardiogenic vasopressor dysfunction (NVD)
Procedure:
1) patient is restrained on a table with feet on a footboard
2) the table is abrubtly tilted 60-90 degrees from the supine position for 10-60 minutes
3) heart rate, blood pressure & symptoms are monitored
4) test is diagnostic if bradycardia or hypotension develops with symptoms of syncope or pre-syncope
5) if hypotension or bradycardia do NOT occur, repeat testing with isoproterenol infusion
Sensitivity: 50-70% (70-90% with isoproterenol infusion)
Specificity: 95% (75% with isoproterenol infusion), 85.5% with nitroglycerin*
* nitroglycerin yields the most positive results [2]
False positives: 10-60% (depending upon study)
Related
vasovagal reaction (fainting)
General
clinical procedure
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- de Ruiter SC, van Marum RJ, Ruiter JH, et al.
Head-up tilt testing in older syncope patients: a systematic review.
Age Ageing. 2025 Mar 28;54(4):afaf086
PMID: 40207380 PMCID: PMC11982670