Reproducibility of Tilt-Table Test Potentiated with Double Dose Sublingual Nitroglycerin in Patients with Suspected Recurrent Syncopal Episodes

Abstract

Introduction: Tilt-table test (TT) is a noninvasive and safe test used for the diagnosis of patients with syncope. Currently, there are controversies about the diagnostic utility and reproducibility of TT. The reproducibility of TT has been reported within a wide range from 36% to 90% for a positive test and from 85% to 100% for a negative test. The aim of the present study was to investigate the current reproducibility of TT. Patients and Methods: All consecutive patients who underwent TT with double dose spray nitroglycerin due to suspected reflex syncope between May 2017 and January 2019 at our hospital were evaluated. Patients underwent a second TT within 1-7 days following the initial test. Results: A total of 135 (76 female, 56.3% and 59 male, 43.7%) patients aged 18-61 (mean (± SD) 32 ± 10.85) years were included in the study. In the first test, 81 (60.0%) patients had a positive response, 51 (37.8%) patients had a negative response, and 3 (2.2%) patients had an exaggerated response. In the repeated test, 75 (55.6%) patients had a positive response, and 60 (44.4%) patients had a negative response. The reproducibility of a positive tilt test was 85.2%, whereas the reproducibility of a negative tilt test was 88.2%. Overall reproducibility was 86.4%. Conclusion: In selected patients, TT with double dose sublingual spray nitroglycerin has a high reproducibility. Double dose sublingual spray nitroglycerin might be used for potentiating TT with acceptable safety.