A Tick of the Clock: Finding the Sweet Spot in Tilt Table Test. The Effectiveness of Short-Duration Head-Up Tilt Test as a Diagnostic Tool in Suspected Vasovagal Patients: A Retrospective Observational Study in a Tertiary Syncope Unit

Abstract

Aims

The head-up tilt test (HUTT) has been markedly changed over the years, especially in the specified time for the passive and active phases. However, a consensus-based protocol has yet to be established.

Methods

Seven hundred twenty-four patients suspected of vasovagal syncope who underwent HUTT through one of the protocols of 15to 20-min testing for each active/passive phase (the whole test duration was 30 or 40 min, respectively) were evaluated. Then, the positive responses were recorded.

Results

470 (64.9%) and 254 (35.1%) patients in the 15- and 20-min groups, respectively. Overall, 238 patients (50.6%) in the 15-min group and 140 patients (55.1%) in the 20-min group had positive responses (p = 0.25). There was no significant difference in the number of positive responses between the 15- and 20-min groups in any of the passive (p = 0.53) and active (p = 0.3) phases.

Conclusion

The 15-min HUTT protocol has similar results to the 20-min protocol. Saving 10 min for each test has several potential benefits, such as increasing patient acceptance, decreasing patient discomfort, and enabling the conduct of more tests in a day in a syncope unit.