Positive head-up tilt table test in patients with the long QT syndrome

Hermosillo, Antonio G.; Falcón, J C; Márquez, Manlio F.; Arteaga, Diana; Cárdenas, Manuel

doi:10.1053/eupc.1999.0056

Cited by 20 publications

(11 citation statements)

References 12 publications

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“…A recent [14] and the present study show that neurocardiogenic syncope can be induced in a majority of LQTS patients demonstrating that other mechanisms may be important. There was a slight tendency towards HUT being more often positive in LQTS than in patients without LQTS referred for HUT due to syncope (P < 0:10).…”

Section: Discussionmentioning

confidence: 88%

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Long QT syndrome patients may faint due to neurocardiogenic syncope

Toft

2003

Europace

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Aims Syncope in long QT syndrome (LQTS) is expected to be due to Torsades de Pointes ventricular tachycardia (TdP). Often these patients faint in situations with emotional stress. The aim of the present study was to evaluate whether neurocardiogenic syncope occurs in LQTS.Methods and results Ten untreated consecutive LQTS patients (age 11-72 years, median 37.5 years, five males and five females from five different families (one KvLQT1 mutation, two HERG mutations in three families and one without established genetic background)) were examined by a head-up tilt-table test (HUT). If syncope did not occur within 25 min, the patient received 0.25 mg nitroglycerine sublingually and the HUT was continued for 20 min. Nine out of 10 patients had a positive HUT. The syncope resulted from a combined vasodepressor and bradycardiac response. There were no cases of TdP. No syncope occurred in a 42-year-old asymptomatic male LQTS patient with a borderline prolonged QTc of 0.45 s and a HERG mutation. In 11 of 21 patients referred for syncope without LQTS a positive HUT was found (P < 0:10).Conclusion Syncope in LQTS can be of neurocardiogenic origin and is not necessarily due to TdP. The reason for neurocardiogenic syncope in LQTS is unknown, but involvement of the autonomic nervous system outside the heart is possible.

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Section: Discussionmentioning

confidence: 88%

“…This is in common with vasovagal syncope, which is a frequently made erroneous diagnosis in LQTS patients, when the QT prolongation is overlooked. In a recent study all the six patients investigated with a head-up tilttable test (HUT) had a positive test of mixed response [14] . No genetic classification was made in that study.…”

Section: Introductionmentioning

confidence: 99%

Long QT syndrome patients may faint due to neurocardiogenic syncope

Toft

2003

Europace

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“…The syncope was subsequently demonstrated to be neurocardiogenic syncope. Abnormal tilt table-table tracing have been linked to prolonged QT syndromes [6] which suggests a neurocardiogenic reflex may aggravate an underlying electrical abnormality should it be present.…”

Section: Discussionmentioning

confidence: 99%

Near death and neurocardiogenic syncope

et al. 2007

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“…19 In fact, small studies have shown that patients with LQTS are prone to VVS. 20,21 Furthermore, in all large series reporting on consecutive patients with BrS, the long-term risk for spontaneous VF for patients initially presenting with syncope is intermediate: lower than that for patients presenting with cardiac arrest but significantly higher than that for initially asymptomatic patients. 22,23 This consistent finding suggests that the BrS patient-group presenting with syncope actually includes 2 different patient populations, one presenting with arrhythmic syncope and malignant course during follow-up and one with vagal syncope and benign prognosis.…”

Section: Symptomsmentioning

confidence: 97%