Head-up tilt test diagnostic yield in syncope diagnosis.
J Electrocardiol
; 63: 46-50, 2020.
Article
en En
| MEDLINE
| ID: mdl-33075618
ABSTRACT
BACKGROUND:
The European Syncope Guidelines (ESG) recommend the use of Head-up tilt test (HUT) in case of suspicion of vasovagal syncope (VVS) or orthostatic hypotensive syncope (OHS) after an adequate initial inconclusive evaluation. We report a single center experience in the scenario of suspected VVS or OHS, who underwent HUT in patients referred to a Syncope Clinic after ruling out high-risk causes.METHODS:
We prospectively and consecutively included all syncopal patients that were referred for HUT, by their attending physician after performing a series of diagnostic tests to rule out cardiac etiology. The clinical history and diagnostic tests performed were reviewed prior to HUT. Patients were pre-classified according to the recommendations from the ESG as; VVS, OHS or Syncope of Unknown Etiology (SUE).RESULTS:
We studied 1058 patients, 558 (52.7%) males, mean age 46.5⯱â¯20.1â¯yr. There were no gender differences in age, risk factors, previous heart diseases, ECG findings or number of previous tests. Based on the ESG criteria a significant number of diagnostic tests were probably unnecessarily performed. HUT was positive in 609 patients (57.5%). The rate of positive HUT according to pre-classification was significantly different among groups 60% VVS, 46.1% OHS and 54.3% SUE (pâ¯=â¯0.037). Combining ESG recommendations and HUT results of the 1058 resulted in 762 (72%) diagnosed as VVS, 89 (8.4%) as OHS and 207 (19.5%) as SUE.CONCLUSIONS:
Appropriate application of ESG recommendations combined with HUT, identified 81% of patients with non-cardiogenic syncope, potentially avoiding a significant number of unnecessary diagnostic tests.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Síncope Vasovagal
/
Electrocardiografía
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Electrocardiol
Año:
2020
Tipo del documento:
Article