© 2002 by European Society of Cardiology
Reproducibility of asystole during head-up tilt testing in patients with neurally mediated syncope
1Department of Cardology, Ospedale valduce, Como Garbagnate Milanese—Italy; 2Department of Cardology, Ospedale G. Salvini Garbagnate Milanese—Italy
Tilt induced prolonged asystole has been considered to identify a distinct subgroup of patients with neurally mediated syncope and management including permanent pacemaker implantation has been suggested. To evaluate the reproducibility of asystolic response during head-up tilt testing (HUT), 33 patients with neurally mediated syncope and asystolic response (
3 seconds) during HUT prospectively underwent two consecutive tests 13±15 days apart. On repeat tilt testing asystole was reproduced in 12 patients (36%), while 8 patients still had a positive HUT, but without asystole. Remarkably, 13 patients (40%) had a negative repeat HUT. Among 12 patients with asystole on both HUTs there was no significant difference in duration of asystole (14 371±11 430 ms vs 13 707±10 470 ms,P =ns) and time to syncope (36±20 min vs 37±20 min, P=ns) during initial and repeat HUTs. In conclusion, asystole during tilt testing does not seem to be a reproducible response.
Key Words: Head-up tilt test, asystole, reproducibility
Correspondence: Dr Giovanni Foglia-Manzillo, Unità Operativa di Cardiologia, Ospedale Valduce, Via Dante 11, 22100 Como, Italy. Tel.: ++39 031 324111; Fax: ++39 031 308047. E-mail: cardiologia{at}valduce.it
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