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

Fitzpatrick, Adam P.; Lee, R. J.; Epstein, Laurence M.; Lesh, Michael D.; Eisenberg, Susan J.; Sheinman, M

doi:10.1136/hrt.76.5.406

Cited by 30 publications

(19 citation statements)

References 15 publications

(5 reference statements)

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“…The sensitivity of passive tilt table testing has been variously reported as 19% to 69%4 13 14 but is mostly poor. Isoprenaline is known to increase the sensitivity while decreasing the specificity of the test,14 15 but it requires an infusion system and is unpleasant to many patients, with relatively frequent side effects 11…”

Section: Discussionmentioning

confidence: 99%

Comparing two different protocols for tilt table testing: sublingual glyceryl trinitrate versus isoprenaline infusion

Oraii

Maleki

Minooii

et al. 1999

Heart

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Objective-To assess the diagnostic value and safety of sublingual glyceryl trinitrate tilt testing compared with isoprenaline infusion in patients with unexplained syncope. Design-Glyceryl trinitrate and isoprenaline tilt tests were performed in two successive days on a random basis in cases and controls. Setting-Outpatient cases with syncope referred to Shahid Rajaii Heart Hospital. Subjects-65 consecutive patients with unexplained syncope after thorough work up; 20 healthy volunteers. Results-Positive responses were observed in 20 patients during the passive phase. Of the other 45 patients, positive responses occurred in 25 cases during the glyceryl trinitrate phase and in 26 cases during the isoprenaline phase. In the control group, positive responses during the passive, glyceryl trinitrate, and isoprenaline phases occurred in one, one, and two cases, respectively. The sensitivity and specificity of the protocols were 55% and 94.7%, respectively, for glyceryl trinitrate v 58% and 89.4% for isoprenaline. Owing to discordant responses in 75% of the cases, the sequential use of the tests (if one was negative) would increase the sensitivity to 84% while decreasing the specificity slightly (to 84%). Side eVects were less frequent with glyceryl trinitrate. Conclusions-Sublingual glyceryl trinitrate tilt testing is an eVective and safe alternative to the isoprenaline infusion test and can be used as a complementary test. (Heart 1999;81:603-605)

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Section: Discussionmentioning

confidence: 99%

Comparing two different protocols for tilt table testing: sublingual glyceryl trinitrate versus isoprenaline infusion

Oraii

Maleki

Minooii

et al. 1999

Heart

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“…This may explain why pacing in neurogenic syncope is often more efficacious than expected [30]. The sensitivity of passive tilt table testing has been variously reported as 19-69% [31][32][33] but is mostly poor. Specificity has been quoted at 90% [1].…”

Section: Sensitivity and Specificitymentioning

confidence: 93%

A randomised prospective comparison of three protocols for head-up tilt testing and carotid sinus massage

Farwell

Sulke

2005

International Journal of Cardiology

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“…Other drugs used as provocative agents during tilt testing include isosorbide dinitrate [114,115] , edrophonium [116,117] , clomipramine [118] and adenosine; the latter is discussed in another section.…”

Section: Tilt Test Protocolsmentioning

confidence: 99%

Guidelines on management (diagnosis and treatment) of syncope

Brignole¹,

Alboni²,

Benditt

et al. 2001

European Heart Journal

670

432

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

Cited by 30 publications

References 15 publications

Comparing two different protocols for tilt table testing: sublingual glyceryl trinitrate versus isoprenaline infusion

Comparing two different protocols for tilt table testing: sublingual glyceryl trinitrate versus isoprenaline infusion

A randomised prospective comparison of three protocols for head-up tilt testing and carotid sinus massage

Guidelines on management (diagnosis and treatment) of syncope

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