PMID: 8963892Nov 1, 1996Paper

Effect of patient characteristics on the yield of prolonged baseline head-up tilt testing and the additional yield of drug provocation

Heart
A FitzpatrickM M Sheinman

Abstract

To define the value of tilt testing and hte additional yield of drug provocation over prolonged baseline tilt in different patient subgroups. (Many different protocols are in use for head-up tilt testing in heterogeneous groups of patients. Not all patients in reported series have recurrent syncope, and there is often a wide age range and a variable incidence of structural heart disease.) In a prospective study, baseline 60 degrees head-up tilt testing was undertaken for 45 minutes, initially without drug provocation. Patients who remained symptom free were given intravenous isoprenaline (isoproterenol) and further tilting or edrophonium (10 mg bolus) during tilt, in an order determined randomly before the start of the test. If they were symptom free after the first drug, they were given the other drug. A positive test was recorded when syncope or pre-syncope occurred with a rapid fall (> 30%) in blood pressure. The impact on tilt result of the type of symptoms, presence of significant structural heart disease (SHD), presence of a non-cardiovascular cause of sudden diminished consciousness (SDC), and age was then assessed by subgroup analysis. 145 patients (73 female, mean age 51 (25), range 8-94) with one or more episodes of p...Continue Reading

References

Mar 15, 1992·Journal of the American College of Cardiology·R Sheldon, S Killam
Mar 1, 1992·Annals of Internal Medicine·W N Kapoor, N Brant
Jan 1, 1991·Journal of the American College of Cardiology·A P FitzpatrickR Sutton
Jul 1, 1990·Journal of the American College of Cardiology·G PongiglioneD W Benson
Aug 1, 1988·Pacing and Clinical Electrophysiology : PACE·F Abi-SamraL W Castle
Mar 25, 1989·Lancet·A Fitzpatrick, R Sutton
Jan 1, 1989·The American Journal of Cardiology·M B WaxmanJ Roseman
Jul 1, 1993·Journal of the American College of Cardiology·R Sheldon

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Citations

Jul 18, 2000·Journal of the American College of Cardiology·A P Fitzpatrick, A Zaidi
Aug 24, 1999·Pacing and Clinical Electrophysiology : PACE·L BeckJ M Davy
Mar 16, 2006·Heart·Adam P Fitzpatrick, Paul Cooper
Oct 28, 2006·Postgraduate Medical Journal·Sanjiv PetkarAdam P Fitzpatrick
Aug 3, 2005·Drugs & Aging·Philippe BordierAlexia Lafitte
Jul 23, 2014·Healthcare Management Forum·Hamid Sadri, Pamela Winsor
Jul 16, 2005·International Journal of Cardiology·D J Farwell, A N Sulke
Feb 12, 2008·Journal of the American College of Cardiology·Maw Pin Tan, Steve W Parry
Jan 10, 2008·The Annals of Pharmacotherapy·Alexander A Fisher, Michael W Davis
Sep 8, 2018·Journal of Cardiovascular Electrophysiology·Parin J PatelEric N Prystowsky

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