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Europace Advance Access originally published online on March 8, 2007
Europace 2007 9(4):220-224; doi:10.1093/europace/eum025
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

SYNCOPE

A new alcohol provocation head up tilt protocol in the patients with alcohol-related syncope

Katsuhiko Tateoka, Yu-ki Iwasaki*, Takuya Ono, Yoshinori Kobayashi, Takao Katoh and Teruo Takano

Department of Internal Medicine, Division of Cardiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 1138603, Japan

Aims Drinking alcohol is known to be one of the triggering factors of neurally-mediated syncope. Little is known about the diagnostic utility of the conventional and alcohol provocation head up tilt-test (HUT) in patients with alcohol-related syncope. We investigated the effect of the alcohol provocation HUT.

Methods and results We studied 12 patients (8 males, age 51 ± 19 years) who had a history of unexplained post-alcohol ingestion syncope. An alcohol provocation protocol HUT (alcohol HUT), in which the protocol required 350 mL of 5% alcohol beer to be drunk over 5 min followed by positioning with the table tilted up for up to 30 min, was performed after the control and isoproterenol (ISP) HUT. None of the subjects (0/12) exhibited a positive response in the control HUT, and only one subject had a positive response (1/12; 8.3%) in the ISP HUT. In the alcohol HUT a positive response (9/12; 75%) increased in the patient group, whereas there were no positive responses in the normal control group.

Conclusion In the conventional HUT protocols, including ISP provocation, it was difficult to produce a positive response in the patients with alcohol-related syncope. Alcohol ingestion was a useful diagnostic provocation method in such patients.

Key Words: Alcohol, Head up tilt-test, Provocation test, Neurally-mediated syncope

* Corresponding author. Tel: +81 3 3822 2131. E-mail address: iwasaki{at}nms.ac.jp

Manuscript submitted 22 December 2006. Accepted after revision 26 January 2007.


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