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Jede Synkope bedarf der Abklärung mit Kipptischuntersuchung: Die Contraposition

Jede Synkope bedarf der Abklärung mit Kipptischuntersuchung: Die Contraposition The neurocardiogenic mechanism is the most frequent reason of syncope. Tilt table testing is the standard procedure to prove diagnoses and guide therapy. However, tilt testing has limitations, which will be discussed in this review. First of all, the methodological validation of the test is incomplete: there are several protocols, which differ in the combination of passive testing and pharmacological provocation, the drugs used for provocation and factors such as tilt angle and in general, passive testing without pharmacological intervention is less sensitive (mean value about 40%) than fairly specific (specificity in the range of 80%). High tilt angles (80°) as well as drugs to provoke syncope on the tilt table increase sensitivity (up to 70%) at the expense of specificity (as low as ≤ 50%). There is a substantial number of patients with typical signs of neurocardiogenic syncope, whose symptoms cannot be provoked by tilt testing even with pharmacological provocation. Many factors influence the test result: age of the patient, fasting period and instrumentation during the test (i. v. needles, etc.), circadian variability, time interval until the spontaneous episode of syncope and cardiovascular drugs. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Herzschrittmachertherapie + Elektrophysiologie Springer Journals

Jede Synkope bedarf der Abklärung mit Kipptischuntersuchung: Die Contraposition

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References (45)

Publisher
Springer Journals
Copyright
Copyright © 2000 by Steinkopff Verlag
Subject
Medicine & Public Health; Cardiology
ISSN
0938-7412
DOI
10.1007/s003990070013
Publisher site
See Article on Publisher Site

Abstract

The neurocardiogenic mechanism is the most frequent reason of syncope. Tilt table testing is the standard procedure to prove diagnoses and guide therapy. However, tilt testing has limitations, which will be discussed in this review. First of all, the methodological validation of the test is incomplete: there are several protocols, which differ in the combination of passive testing and pharmacological provocation, the drugs used for provocation and factors such as tilt angle and in general, passive testing without pharmacological intervention is less sensitive (mean value about 40%) than fairly specific (specificity in the range of 80%). High tilt angles (80°) as well as drugs to provoke syncope on the tilt table increase sensitivity (up to 70%) at the expense of specificity (as low as ≤ 50%). There is a substantial number of patients with typical signs of neurocardiogenic syncope, whose symptoms cannot be provoked by tilt testing even with pharmacological provocation. Many factors influence the test result: age of the patient, fasting period and instrumentation during the test (i. v. needles, etc.), circadian variability, time interval until the spontaneous episode of syncope and cardiovascular drugs.

Journal

Herzschrittmachertherapie + Elektrophysiologie – Springer Journals

Published: Nov 20, 2000

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