Significance of Tilt Table Testing in Patients with Suspected Arrhythmic Syncope and Negative Electrophysiologic Study

García‐Civera, Roberto; Ruiz‐Granell, Ricardo; Morell-Cabedo, Salvador; Sanjuan-Mañez, Rafael; Ferrero, Àngel; Martínez-Brotons, Ángel; Roselló, Araceli; Botella, S; Llàcer, Àngel

doi:10.1111/j.1540-8167.2005.50029.x

Cited by 17 publications

(11 citation statements)

References 23 publications

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“…1 and 9) now known to have prolonged asystolic syncope. These results are consistent with those in 81 adults with suspected arrhythmic syncope reported by Garcia-Civera et al, 19 who found no statistical association between tilt-table test results and the mechanism of syncope found with the implantable loop recorder.…”

Section: Discussionsupporting

confidence: 95%

Digital implantable loop recorders in the investigation of syncope in children: Benefits and limitations

et al. 2006

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Section: Discussionsupporting

confidence: 95%

Digital implantable loop recorders in the investigation of syncope in children: Benefits and limitations

et al. 2006

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“…Deharo et al showed that the heart rhythm observed during spontaneous syncope in vasovagal patients with ILRs does not correlate with head-up tilt test 28. Garcia-Civera et al demonstrated that a negative electrophysiological study and head-up tilt test is of little value to predict the mechanism of syncope 29. Thus, a strategy based on early application of ILRs allows a specific and effective treatment in patients with unexplained syncope 30.…”

Section: Discussionmentioning

confidence: 99%

Implantable loop recorder in unexplained syncope: classification, mechanism, transient loss of consciousness and role of major depressive disorder in patients with and without structural heart disease

Pezawas

Stix

Kästner

et al. 2007

Heart

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“…Tilt testing is of limited value in patients with unexplained syncope as a positive test does not exclude a primary arrhythmic cause. Long-term monitoring, with an implantable loop recorder if necessary, is more likely to elicit a diagnosis [24,25,26]. …”

Section: The Young Patient With Cardiac Symptomsmentioning

confidence: 99%

Sudden Cardiac Death in the Young: A Strategy for Prevention by Targeted Evaluation

Sen‐Chowdhry

McKenna

2006

Cardiology

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The annual incidence of sudden cardiac death (SCD) in the general population is estimated as 1 in a 1,000. Since survival rates from out-of-hospital cardiac arrests are poor, primary prevention is key to reducing the burden of SCD in the community. Prominent causes of SCD include ischaemic heart disease, anomalous coronary arteries, and the primary myocardial diseases: hypertrophic cardiomyopathy, dilated cardiomyopathy, and ar rhythmogenic right ventricular cardiomyopathy (ARVC). In 4% of sudden deaths in the 16–64 age group, post-mortem examination fails to identify a cause, yielding a default diagnosis of sudden arrhythmic death syndrome (SADS). The inherited arrhythmia syndromes (long QT, short QT, and Brugada syndromes, and familial catecholaminergic polymorphic ventricular tachycardia) may be implicated in SADS, owing to their propensity for producing ventricular tachyarrhythmia in the structurally normal heart. Monogenic disorders therefore predominate as causes of SCD in the young. The advent of effective therapies for these diseases, particularly implantable cardioverter defibrillators, has prompted calls for universal screening to enable timely diagnosis of occult cardiac disease. Since prospective cardiac assessment of the general population is not feasible, the solution may be to target high-risk subgroups, namely, patients with cardiac symptoms, relatives of SCD victims, and competitive athletes. The recommended preliminary work-up includes a 12-lead ECG, signal-averaged ECG, transthoracic echocardiogram, exercise test, and ambulatory ECG monitoring. Cardiovascular magnetic resonance is a useful adjunct in patients with suspected ARVC or anomalous coronary arteries. Provocative challenge with a sodium challenge blocker may be of value in unmasking the Brugada syndrome. Identification of disease-causing mutations in affected individuals facilitates cascade screening of families.

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Significance of Tilt Table Testing in Patients with Suspected Arrhythmic Syncope and Negative Electrophysiologic Study

Abstract: In patients with a suspected arrhythmic etiology for syncope and a negative EPS, TTT is of little value to predict the mechanism of syncope and the ILR implantation seems to be a useful and safe diagnostic strategy.

Cited by 17 publications

References 23 publications

Digital implantable loop recorders in the investigation of syncope in children: Benefits and limitations

Digital implantable loop recorders in the investigation of syncope in children: Benefits and limitations

Implantable loop recorder in unexplained syncope: classification, mechanism, transient loss of consciousness and role of major depressive disorder in patients with and without structural heart disease

Sudden Cardiac Death in the Young: A Strategy for Prevention by Targeted Evaluation

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