The Role of Tilt Training in Preventing Recurrent Syncope in Patients with Vasovagal Syncope: A Prospective and Randomized Study

Abstract

Tilt training was unable to influence the spontaneous syncope recurrence for recurrent VVS except for vasodepressor type.

Treatment of Vasovagal Syncope: An Update

“…Spontaneous syncope recurrence occurred in 56% of patients in the control group compared with 37% of patients in the tilt training groups (P=0.1). Time to first recurrence was also similar in both groups (70±20 days vs 50±15 days, P=0.09), as was the mean number of recurrent syncope episodes (3±1 vs 2±1, P= 0.4) ( Table 1) [17]. Pharmacologic treatment…”

“…On et al [16] demonstrated similar follow-up HUT responses and no differences in the occurrence of spontaneous syncope or presyncope between the two groups. Home orthostatic selftraining was also found to be ineffective in the study conducted by Duygu et al [17]. Spontaneous syncope recurrence occurred in 56% of patients in the control group compared with 37% of patients in the tilt training groups (P=0.1).…”

“…Although the prescription of tilt training in highly motivated young patients with recurrent VVS may reduce the recurrence of syncope [13,14], three randomized controlled trials failed to confirm shortterm effectiveness in preventing tilt-induced VVS and reducing longterm syncope recurrence [15,16,17]. & Foglia-Manzillo et al [15] evaluated tilt training and used a positive HUT as outcome.…”

Does non-pharmacological treatment affect outcomes in dysautonomic syndromes?

“…Experimental studies demonstrated a possible effect on the vasoconstriction reserve [19]. However, randomized controlled trials are controversial and do not confirm the effectiveness of tilt testing, especially because of poor compliance in continuing the training for longer periods [20][21][22].…”

Ocena skuteczności zastosowania treningów pionizacyjnych oraz edukacji pacjenta w prewencji omdleń odruchowych u chorych z zespołem wazowagalnym, hospitalizowanych w Klinice Choroby Wieńcowej i Niewydolności Serca w latach 2010–2015

“…The success of the therapy proposed by Ector et al was impressive, because it resulted in complete elimination of reflex syncope episodes in all 13 patients. Unfortunately, results of subsequent studies on these methods were not so evident [2][3][4]. Considering that alternative effective therapies are lacking, TT still remains one of the basic methods used in the treatment and/or prevention of recurrent reflex syncope [5], despite low class of recommendation in the European Society of Cardiology (ESC) guidelines (IIb, B).…”