Tilt-test in estimating syncope conditions in children and teenagers
L.M. MAKAROV
Head of Center for Syncope conditions and heart arrhythmia in children and teenagers of Central Children’s Clinical Hospital, 20, Moskvorechye St., Moscow, Russian Federation, 115409
Makarov L.M. — D. Med. Sc., Professor, Head of Center for Syncope conditions and heart arrhythmia in children and teenagers of Central Children’s Clinical Hospital, President of the Russian Society for Holter monitoring and Noninvasive Electrophysiology (RSHMNE), tel. (499) 324-57-56, e-mail: leonidmakarov@yahoo.com
The lecture describes the modern views on pathogenesis, clinics and treatment of syncopic (fainting) conditions. New definitions of syncope are given, based on the recent recommendations of the leading international societies of cardiologists, neurologists, therapists and other specialists who deal with the issue in their practice. The main attention is paid to the leading technique of reflex syncope diagnostics — a passive test on a spin table, or tilt-test. The indication for the technique are defined, as well as the main results of the research, which determine the differential approaches to syncope treatment and prognosis.
Key words: syncope (fainting), tilt-test, treating and predicting of faints.
REFERENCES
- Moya A., Sutton R., Ammirati F. et al. Guidelines for the diagnosis and management of syncope (version 2009). The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). European Heart Journal, August 27, 2009.
- Wieling W., Krediet P., van Dijk N., Linzer M. e al. Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond), 2007;112:157-165.
- Grubb B.P., Kosinski D.J., Boehm K., Kip K. The postural orthostatic tachycardia syndrome: a neurocardiogenic variant identified during head-up tilt table testing. Pacing Clin Electrophysiol, 1997;20:2205-2212.
- Vlahos A.P., Kolettis T.M. Family history of children and adolescents with neurocardiogenic syncope. Pediatr Cardiol., 2008;29:227.
- Kenny R.A., Ingram A., Bayliss J., Sutton R. Head-up tilt: a useful test for investigating unexplained syncope. Lancet, 1986;1:1352-1355.
- Wieling W., Ganzeboom K.S., Saul J.P. Reflex syncope in children and adolescents. Heart, 2004;90:1094-1100.
- Bass E.B., Curtiss E.I., Arena V.C. et al. The duration of Holter monitoring in patients with syncope: is 24 h enough? ArchInternMed, 1990;150:1073-1078.
- Schuchert A., Maas R., Kretzschmar C. et al. Diagnostic yield of external loop recorders in patients with recurrent syncope and negative tilt table test. Pacing Clin Electrophysiol., 2003;26:1837-1840.
- Brignole M., Ungar A., Bartoletti A., Ponassi I., Lagi A., Mussi C., Ribani M.A., Tavav G., Disertori M., Quartieri F., Alboni P., Raviele A., Ammirati F., Scivales A., De Santo T. Evaluation of Guidelines in Syncope Study 2 (EGSYS-2) GROUP. Standardizedcare pathway vs. usual management of syncope patients presenting as emergencies at general hospitals. Europace, 2006;8:644-650.