Document Detail


Application of head-up tilt table testing in children.
MedLine Citation:
PMID:  20863991     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: We investigated the application of head-up tilt table testing (HUT) and management of neurocardiogenic syncope (NCS) in children, as pediatric studies are limited. METHODS: Seventy-nine patients (ages 6-18 years) underwent HUT for evaluation of syncope. Patient triggers and premonitory symptoms allowed the clinical diagnosis of NCS or non-NCS. Results were divided into four hemodynamic types (1, 2A, 2B, and 3) according to patient response to HUT. RESULTS: NCS occurred in 65 patients and non-NCS in 14 patients. Isoproterenol infusion significantly increased the sensitivity of the test (from 28% to 45%) and was associated with a slight decrease in the specificity (from 93% to 86%). Subjects in the type 1 group accounted for the majority of responses to the test (69%). There were no complications associated with the test. At follow-up (16.6 ± 9.3 months), the overall recurrence rate was 30.8% but NCS was less severe in most patients. The recurrence rate was similar for patients with a positive or negative HUT and for both pharmacologically and non-pharmacologically treated patients. CONCLUSION: HUT can be safely performed with a high specificity in children, with the sensitivity of HUT improved by isoproterenol. Therefore, a positive response to treatment is reassuring to the physician and family. NCS is generally a self-limited condition despite a high recurrence rate.
Authors:
Wei-Ting Lai; Ming-Ren Chen; Shan-Miao Lin; Haw-Kwei Hwang
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the Formosan Medical Association = Taiwan yi zhi     Volume:  109     ISSN:  0929-6646     ISO Abbreviation:  J. Formos. Med. Assoc.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2010-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214933     Medline TA:  J Formos Med Assoc     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  641-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Cohort Studies
Female
Follow-Up Studies
Humans
Infusions, Intravenous
Isoproterenol / administration & dosage*,  diagnostic use
Male
Recurrence
Sensitivity and Specificity
Severity of Illness Index
Syncope, Vasovagal / diagnosis*,  physiopathology
Tilt-Table Test / adverse effects,  methods*
Chemical
Reg. No./Substance:
7683-59-2/Isoproterenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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