Author:

Keywords:

Syncope, tilt training, tilt table testing, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, 3201 Cardiovascular medicine and haematology

Abstract:

Syncope recurrence is strikingly reduced after tilt training in patients with neurally mediated syncope compared to controls T. Reybrouck, H. Heidbüchel, R. Willems Departments Cardiology and Cardiovascular Rehabilitation, University Hospital Gasthuisberg, 3000 Leuven Tilt training is considered as a first line treatment for patients with neurally mediated syncope (NMS). This study reports the overall results of a group of 346 patients (mean age: 32.7 ± 21.5 years, range 6.5 – 87 years) with recurrent neurally mediated syncope (S) and a positive tilt test, who underwent a program of tilt training which was started in the hospital. The patients were heavy symptomatic before tilt training: 72 % reported 1 S/year, 12 % ≥ 1 S /month, 12% ≥ 1 S/week and 4 % ≥ 1 S /day. These patients were followed for 1 year at the outpatient clinic. Methods: Patients were tilted daily on a tilt table (60 ° inclination) until syncope, until severe orthostatic intolerance or until a normal value of 45 min was reached. A group of 324 pts continued tilt training on a regular basis and was compared to a group of 22 patients who discontinued or did not perform TT for logistic reasons. This was considered as the control group. The recurrence rate of syncope was followed at the outpatient clinic. Results: More than 80 % of patients with NMs and good compliance to therapy remained free of syncope during a one year follow up. Conclusion: Tilt training restores orthostatic tolerance in patients with NMS and should be continued on a regular and long term basis to condition the orthostatic cardiovascular reflexes. Syncope recurrence during follow up Recurrence rate of syncope (N/year) TT continued (%) (N = 324) Control group (%) (N =22) 0 83 18 1 9 41 ≥ 2 8 41