Reproducibility of head-up tilt-table testing in pediatric patients with neurocardiogenic syncope

The aim of this study is to assess the reproducibility of a head-up tilt-table test protocol so it may be used to more accurately evaluate the effectiveness of a treatment protocol. Children between the ages of 10 and 18 years presenting to the cardiology department at Children's Hospital of Wisconsin with a diagnosis of neurocardiogenic syncope were eligible for the study. The patients were tilted to 70° for 30 minutes or until a positive test occurred. Patients with a positive test were retilted using the same protocol. Parameters measured included heart rate, blood pressure, and the presence or absence of syncope or presyncope. Twenty-two patients were enrolled in the study. Seventeen patients had a positive test on first tilt. Fifteen had a positive tilt test on the second tilt. There were no significant differences between the two tilts with regard to mean differences of baseline heart rate, systolic blood pressure, or mean arterial pressure. There were no significant differences between the two tilts with regard to mean differences in time until symptoms, heart rate, systolic blood pressure, or mean arterial blood pressure at time of symptoms. This study shows that the head-up tilt-table test protocol used is reproducible in adolescents with the diagnosis of neurocardiogenic syncope.