Specificity of Head-Up Tilt Testing in Adolescents: Effect of Various Degrees of Tilt Challenge in Normal Control Subjects

Lewis, David A.; Zlotocha, Jane; Henke, Laura; Dhala, Anwer

doi:10.1016/s0735-1097(97)00255-6

Cited by 63 publications

(36 citation statements)

References 17 publications

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“…17 The passive HUT test has a high specificity but only a moderate sensitivity in the diagnosis of neurocardiogenic syncope. 18 Echocardiography and invasive EPS have a limited yield in the evaluation of syncope in patients with no cardiac history. 4,19 In adults with recurrent undiagnosed syncope, ILR technology allowed for symptom-rhythm correlation in 52% to 94% of patients.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Implantable Loop Recorders in Establishing Symptom-Rhythm Correlation in Young Patients With Syncope and Palpitations

et al. 2003

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ABSTRACT. Objective. To evaluate efficacy of the recently introduced implantable loop recorder (ILR) in establishing symptom-rhythm correlation in young patients with syncope, near syncope, palpitations, and acute life-threatening events (ALTEs).Methods. A retrospective study was conducted with patients with ILR from 3 pediatric centers. Inclusion criteria were age <25 years and a minimum follow-up of 1 month. All ILR-stored events were analyzed regularly for the presence or absence of an arrhythmia at the time of the symptomatic event.Results. Twenty-one patients (12 male, 9 female) with an average age of 12.3 ؎ 5.3 years (range: 0.8 -22 years) were included in the study. Five (24%) patients had structural heart disease, 2 (10%) had a family history of sudden cardiac death, 3 (14%) had QT prolongation on electrocardiogram, and 11 had no cardiovascular disease. Indications for ILR were recurrent syncope and near syncope (n ‫؍‬ 15), palpitations (n ‫؍‬ 2), and ALTE (n ‫؍‬ 2). Fourteen (67%) patients continued to have symptoms, and 7 (33%) had no symptoms after ILR over a follow-up period of 8.4 ؎ 4.7 months (range: 1.9 -16 months). Symptom-rhythm correlation was possible in all 14 patients who continued to have symptoms (supraventricular tachycardia in 4, ventricular tachycardia in 2, torsades de points in 1, asystole in 1, junctional bradycardia in 1, and sinus rhythm in 5).Conclusions. ILR is useful in determining the presence or absence of an arrhythmia during symptoms of syncope, near syncope, and palpitations as well as ALTEs in patients with and without structural heart disease when conventional diagnostic testing, such as electrocardiogram, Holter monitoring, and/or external loop recording, is inconclusive. Pediatrics 2003;112:e228 -e233. URL: http://www.pediatrics.org/cgi/content/full/112/3/e228; implantable loop recorder, arrhythmias, syncope, palpitations.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Implantable Loop Recorders in Establishing Symptom-Rhythm Correlation in Young Patients With Syncope and Palpitations

et al. 2003

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“…Tilt protocols commonly used in adults lack specificity in teenage patients. In order to obtain acceptable specificity tilt test duration should be shorter in teenagers than in adults; in one study [401] specificity was >85% by performing the tilt test at 60 or 70 for no longer than 10 min. Regardless of the results of the tilt test, almost all patients with neurally-mediated syncope have improved or resolved symptoms with simple interventions during long-term follow-up [402] .…”

Section: Diagnostic Work-upmentioning

confidence: 99%

Guidelines on management (diagnosis and treatment) of syncope

Brignole¹,

Alboni²,

Benditt

et al. 2001

European Heart Journal

680

432

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“…The tilt-table test is used as a method for the evaluation of syncope of unknown cause and it usually confirms the diagnosis of NMS. Its use in pediatrics is controversial due to the fact that several groups have demonstrated sensitivities of 43% to 57% and specificities of 83% to 100% (16).…”

Section: Clinical Evaluationmentioning

confidence: 99%

Syncope in Children and Adolescents

Pejčić¹,

Janković²,

Mileusnić-Milenović³

et al. 2017

Acta Facultatis Medicae Naissensis

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Specificity of Head-Up Tilt Testing in Adolescents: Effect of Various Degrees of Tilt Challenge in Normal Control Subjects

Abstract: Children appear to be more susceptible to orthostatic stress than adults. Therefore, tilt protocols commonly used in adults lack specificity in teenage patients. A specificity > 85% may be obtained by performing the tilt test at 60 degrees or 70 degrees for no longer than 10 min.

Cited by 63 publications

References 17 publications

Efficacy of Implantable Loop Recorders in Establishing Symptom-Rhythm Correlation in Young Patients With Syncope and Palpitations

Efficacy of Implantable Loop Recorders in Establishing Symptom-Rhythm Correlation in Young Patients With Syncope and Palpitations

Guidelines on management (diagnosis and treatment) of syncope

Syncope in Children and Adolescents

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