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“…In the tiltpositive response group, withdrawal of sympathetic activity and increased parasympathetic activity occur, demonstrating abnormal compensatory responses. [10][11][12][13] Abrupt sympathetic withdrawal results in rapidly decreasing blood pressure (BP) and syncope in susceptible individuals with low central serotonin levels. 14 Syncope can be induced during tilt by an epinephrine surge, 15 or it may be related to increased levels of endogenous opioids.…”
Section: Introductionmentioning
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“…In the tiltpositive response group, withdrawal of sympathetic activity and increased parasympathetic activity occur, demonstrating abnormal compensatory responses. [10][11][12][13] Abrupt sympathetic withdrawal results in rapidly decreasing blood pressure (BP) and syncope in susceptible individuals with low central serotonin levels. 14 Syncope can be induced during tilt by an epinephrine surge, 15 or it may be related to increased levels of endogenous opioids.…”
Section: Introductionmentioning
“…Impairment of vasomotor activity via the sympathetic and/or parasympathetic nervous systems has been reported to be the main etiological basis of hypotension and/or bradycardia in neurally mediated syncope. [6][7][8][9][10] Head-up tilt testing is generally used as a diagnostic method in neurally mediated syncope, [11][12][13][14][15][16][17][18][19][20][21][22] and autonomic vasomotor function assessed by frequency-domain analysis of electrocardographic RR variations is now applied for evaluating autonomic nervous activity in cardiovascular disease. 23,24 To determine the role of vasomotor dysfunction in hemodynamic instability during PSVT attacks, we tested if (1) the type of PSVT, QRS rate, or an electrophysiological variable is correlated with serial blood pressure changes during PSVT, (2) the head-up tilt test can induce hemodynamic instability that is independent of tachycardia and (3) variation in heart rate is an indicator of autonomic dysfunction in PSVT.…”
Section: Introductionmentioning
“…For VVC testing, reproducibility appears to be 65% to 85%, and negative initial tests are more likely to be reproducible than positive initial tests. 38,39 Moreover, the rate of positive responses appears to decrease with short-term sequential head-up tilt tests, although the number of tests performed does not appear to modify the rate of positive responses. [40][41][42] Measurement of OH using passive head-up tilting shows more-consistent outcomes, with high reproducibility (correlation coefficient 5 0.82-0.98) in older persons.…”
Section: Discussionmentioning