Tilt Test

Why do you need a Tilt Test?

A tilt test is a safe way to reproduce your symptoms of neurocardiogenic syncope in order to confirm the diagnosis and to determine appropriate treatment for you.

What should you expect during a Tilt Test?

Preparing for the test:

• You will be asked not to eat or drink anything for six hours before the test.

• If there is a chance that you may be pregnant, please be sure to let your doctor know.

• Blood tests and possibly an EKG (electrocardiogram) may be ordered for you.

• You may have an intravenous line inserted into a vein in your arm.

• You may have an arterial line inserted into the arm or groin.

• You'll be taken to the EP lab about 30 minutes before your scheduled test time.

During the Test:

• The tilt test is performed in the electrophysiology (EP) lab.

• You will be awake for the test.

• Your heart rate and blood pressure will be checked while you lie flat on a "tilt table".

• The table will slowly tilt you upright to a 70º angle.

• Your heart rate and blood pressure will be continuously monitored with a blood pressure cuff on the arm or a small 2-inch catheter in the artery in the wrist or groin.

• The test may take up to 40 minutes.

• Certain IV medications including isoproterenol (Isuprel) may be given during the test.

• If the above test is positive (blood pressure and heart rate drop and you experience your usual symptoms), the diagnosis is confirmed. At this point, you may be given another medication through the IV catheter, and the test will be repeated as before to check the effectiveness of this medication.

How is neurocardiogenic syncope treated?

Once your doctor makes a diagnosis of neurocardiogenic syncope, treatment with medications may or may not be recommended (depending on what triggers the faint, and on how often and how severe your episodes of dizziness or fainting have been). This is a very individual discussion and decision.

You yourself can do many things to prevent or lessen your symptoms of neurocardiogenic syncope:

General Measures

• Learn to sit up and stand slowly.

• Avoid sitting or standing for long periods of time. Keep flexing or exercising your leg muscles frequently.

• Drink plenty of fluids, especially juices and high-sodium drinks. (Check with your doctor first).

• Increase salt intake with your diet. (Check with your doctor first).

• Limit alcohol intake. Alcohol may make you susceptible to fainting.

• Avoid excessive heat and humidity.

• Exercise regularly.

• Begin regular tilt-training if recommended by your doctor.

What is Tilt Training?

Please do not attempt to do these exercises unless recommended by your physician. Tilt training should be performed in a supervised environment.

• Stand against a wall with your feet together (about 1 foot away from the wall).

• Do this exercise every day. Begin with 10 minutes and gradually increase the length of time as follows:
  

  • Day 1-2: 10 minutes

  • Day 3-4: 20 minutes (or two 10-minute sessions)

  • Day 5-6: 30 minutes (or two 15-minute sessions)

  • Day 7 and beyond: 40 minutes (or two 20-minute sessions)
    

• You will be asked to keep a diary indicating the date, the number of minutes you performed the exercise and the symptoms you experie

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