Document Detail


Predictors of positive head-up tilt test in patients with suspected neurocardiogenic syncope or presyncope.
MedLine Citation:
PMID:  12710319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neurocardiogenic syncope is the most common cause of syncope in patients who present in outpatient clinics. Head-up tilt test (HUT) has been widely used to diagnose neurocardiogenic syncope. However, the HUT does not always produce a positive response in patients with suspected neurocardiogenic syncope. The aim of the present study was to assess the clinical history and characteristics of patients with suspected neurocardiogenic syncope or presyncope who undertook HUT, and to identify prognostic factors of a positive HUT response. During the first phase of HUT, patients were tilted to a 70-degree angle for 30 minutes. If the first phase produced a negative response, the second phase was subsequently performed involving intravenous isoproterenol administration. Of 711 patients, 423 (59.5%) patients showed a positive HUT response. In contrast to previous studies, this study showed that the vasodepressive type (76.6%) was the most common pattern of positive response, and that the rate of positive response during the first phase was low (7.1%). By multivariate analysis, the occurrence of junctional rhythm was found to be a predictor of an impending positive response in HUT (P < 0.001). The shorter time interval between the last episode and HUT was also a predictor of positive response (P = 0.0015). Younger age (P = 0.0003) and a history of physical injury during a syncopal episode (P = 0.019) were found to be associated with a positive response in the first phase of HUT.
Authors:
Ju Hyeon Oh; June Soo Kim; Hyun Cheol Kwon; Kyung Pyo Hong; Jeong-Euy Park; Jung Don Seo; Won Ro Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-04-24     Completed Date:  2003-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Masan Samsung Hospital, Masan, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / diagnostic use
Adult
Female
Hemodynamics / physiology
Humans
Isoproterenol / diagnostic use
Logistic Models
Male
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
Syncope, Vasovagal / diagnosis*
Tilt-Table Test*
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 7683-59-2/Isoproterenol

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


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