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) False positives: 10-60% (depending upon study)

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998