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The Tilt Test in the Assessment of Syncope and Pre-syncope. Effective and safe? Analysis of a Series of 2364 Patients over 6 Years

2024; Volume: 37; Linguagem: Inglês

10.24207/jca.v37i1.3490

2674-7472

Eduardo Arrais Rocha, Bruna Sobreira Kubrusly, Aléssia de Alencar Araripe Gurgel, Luís Gustavo Bastos Pinho, Ana Gabriela Ponte Farias, Vitor Olímpio Coimbra, Pedro Sales Pereira Gondim, Maria Camila Timbó Rocha, Maria Eduarda Quidute Arrais Rocha, Francisca Tatiana Moreira Pereira, Vera Regina Beltrão Marques, Roberto Lima Farias, Eduardo Arrais Rocha,

Cardiovascular Syncope and Autonomic Disorders

The tilt table test (TT) provides relevant information about individual susceptibility to neuro-mediated hypotension and bradycardia. Its importance has been questioned. In this work, we analyze the results and safety of TT in the investigation of syncope, presyncope or postural dizziness. Cross-sectional study, with TT exams performed by specialists in cardiac arrhythmias, in the period 2016-2021, in a syncope unit. Analyzes were performed using the Mann-Whitney test, multiple logistic regression, with a significant p value <0.05. The protocols used were Westminster or Italian protocol. There were 2364 TT performed, 61.7% female, aged 51.1 (31-71) years. The positivity rate was 32.6%, 37.2% with pharmacological sensitization (p< 0.01). For the investigation of syncope, positivity was 34.2% (477) x 30.65% (285) for other symptoms (p<0.001), while evaluating syncope and presyncope together the difference was 37.55% (623) x 20.9% (139) for other symptoms (p<0.001). Positivity was higher in males (p<0.01; OR=1.40(1.16-1.69)), in sensitized tests (p<0.01;2.01(1.64-2, 38)), in patients with early orthostatic hypotension (OH) with symptoms (p <0.01; 9.68(4.13-27.44)). The complication rate was 3.29%, but without severity. The TT remains an important and safe methodology in clinical practice for the investigation of patients with suspected neurally mediated syndromes.