A Tick of the Clock: Finding the Sweet Spot in Tilt Table Test. the Effectiveness of Short-Duration Head-Up Tilt Test As a Diagnostic Tool in Suspected Vasovagal Patients: A Retrospective Observational Study in a Tertiary Syncope Unit Publisher



Kalhor P ; Ghahari P ; Asgary N ; Jalali A ; Sadeghian S
Source: Journal of Arrhythmia Published:2025

Abstract

Aims: The head-up tilt test (HUTT) has been markedly changed over the years, especially in the specified time for the passive and active phases. However, a consensus-based protocol has yet to be established. Methods: Seven hundred twenty-four patients suspected of vasovagal syncope who underwent HUTT through one of the protocols of 15to 20-min testing for each active/passive phase (the whole test duration was 30 or 40 min, respectively) were evaluated. Then, the positive responses were recorded. Results: 470 (64.9%) and 254 (35.1%) patients in the 15- and 20-min groups, respectively. Overall, 238 patients (50.6%) in the 15-min group and 140 patients (55.1%) in the 20-min group had positive responses (p = 0.25). There was no significant difference in the number of positive responses between the 15- and 20-min groups in any of the passive (p = 0.53) and active (p = 0.3) phases. Conclusion: The 15-min HUTT protocol has similar results to the 20-min protocol. Saving 10 min for each test has several potential benefits, such as increasing patient acceptance, decreasing patient discomfort, and enabling the conduct of more tests in a day in a syncope unit. © 2025 Elsevier B.V., All rights reserved.