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Revista Costarricense de Cardiología

Print version ISSN 1409-4142

Abstract

ARAYA GOMEZ, Vivien  and  TREJOS-MONTOYA, José Andres. La prueba de inclinación (“Tilt Test”). 20 años de experiencia en el diagnóstico del Síncope neurocardiogénico Tilt Test: 20 years of experience in the diagnosis of the neurocardiogenic syncope. Rev. costarric. cardiol [online]. 2018, vol.20, suppl.1, pp.8-15. ISSN 1409-4142.

Tilt Test: 20 years of experience in the diagnosis of the neurocardiogenic syncope

Objective:

To evaluate the results of the tilt tests carried out during 2 decades.

Methods: This is an observational, descriptive and retrospective study. We analyzed the results of the tilt tests conducted between 1997 and 2018 consecutively by a single person, initially at the “Hospital Clínica Bíblica”, later at the “Instituto del Corazón” and finally in the last 17 years at the “Centro Cardiológico Integral”.

Results:

A total of 2705 tests were carried out between 1997 and 2018. Sixty percent were female. There were 245 tests for people under 20 years (17.3%), 996 tests for people between 20 and 40 years (36.8%), 969 tests for patients between 40 and 60 years (35.8%) and 271 patients older than 60 years (10%). Of the total sample evaluated, 2316 patients presented a positive result for some of the different types of response in the tilt test, equivalent to 85.6%, while 389 patients obtained a negative result (normal response), equivalent to 14.4%. In the largest number of patients, the positivity of the test was presented in phase II, 72.7% (1683 patients), and 27.3% (633 patients) manifested it in phase I. A vasodepressant response was presented in 1120 patients (48.2%), mixed response in 727 patients (31.3%), cardioinhibitory response in 304 cases(13.1%). In addition, 69 patients presented a suggestive response (2.9%) and 104 patients had other types of responses (4.5%). Of the latter, 48% corresponded to orthostatic postural tachycardia syndrome (POTS), 17% to chronotropic incompetence, 19% to orthostatic hypotension and 16% to dysautonomia. A total of 43 patients (1.6%) presented hypersensitivity of the carotid sinus.

Conclusions:

Tilt test in our environment has an adequate sensitivity in the diagnosis of the neurocardiogenic syncope in different age groups, it is a safe method, easy to perform and accessible to most people who require it.

Keywords : Tilt test; neurocardiogenic syncope; syncope; dysautonomia; hypotension.

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