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Europace 1999 1(4):213-217; doi:10.1053/eupc.1999.0056
© 1999 by European Society of Cardiology
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Positive head-up tilt table test in patients with the long QT syndrome

A.G. Hermosillo, J.C. Falcón, M.F. Márquez, D. Arteaga and M. Cárdenas

Department of Electrophysiology, and Division of Clinical Research, Instituto Nacional de Cardiologia ‘Ignacio Chávez’ Mexico City, Mexico

AIMS: Syncope in patients with the long QT syndrome is commonly attributed to a ventricular arrhythmia (torsades de pointes). The susceptibility of patients with the long QT syndrome (LQTS) to neurally mediated syncope is currently unknown.

METHODS AND RESULTS: Head-up tilt table testing (70°) was performed in six patients with the long QT syndrome and a history of syncope. All patients had syncope with a mixed response. The RR interval was significantly decreased 2 min before the onset of syncope (980±125 ms vs 630±91 ms, P=0·003), and significantly increased during syncope (983·17±224·71;P=0·006). Non-significant changes in QT intervals were observed. Baseline QT was 513±86 ms and decreased to 450±59 ms 2 min before the onset of syncope (P=0·11). Although not statistically significant, QT intervals during syncope were longer than at 2 min before syncope (485±85 ms vs 450±59 ms;P=0·29).

CONCLUSION: Our results suggest that patients with the LQTS are susceptible to neurally mediated syncope. Whether this susceptibility differs from control populations remains unresolved. From a clinical standpoint, neurocardiogenic syncope should be considered a diagnostic alternative in patients with LQTS.

Key Words: Long QT syndrome, neurally mediated syncope, head-up tilt table testing

Correspondence: Manuel Cárdenas, MD, Chief, Division of Clinical Research, Instituto Nacional de Cardiología ‘Ignacio Chávez’ Juan Badiano # 1 México, DF 14080, Mexico.


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