SHORT HEAD-UP TILT TEST

EVALUATION OF TIME TO SYNCOPE IN NITROGLYCERINE POTENTIATED

Abstract

Objective: The aim of the present study was to evaluate the time to syncope in Nitroglycerine potentiated short Head-up tilt test.
Study Design, Settings & Duration: This was a descriptive cross sectional study conducted in Armed Forces Institute of cardiology from May
2006 to May, 2007. Patients and methods: A total number of 90 patients with orthostatic intolerance both male and female were studied.
Head-up tilt test protocol consisted of a Stabilization phase which lasted for five minutes Passive tilt phase: Patients were tilted at 70̊ for
orthostatic stress for 15 minutes. In case of no symptoms the test continued with the drug provocation phase which lasted for 15 minutes. The
patients were administered 400μg of nitroglycerine sublingually in aerosol preparation. Development of symptoms were noted at 5, 10 and 15
minutes. Results: A total number of 90 patients were examined during the study period. The tilt table test was classified as positive in 58.9 % of
patients and was negative in 41.1%. The test was positive in five patients without the drug provocation (9.4%). The responses were classified
as positive vasodepressor in 35.8%, 15.09% as mixed and cardioinhibitory 15.09% in patients of neurally mediated syncope. The total time to
display of symptoms to positivity in HUTT was 17.89± 6.99. The mean time to syncope after the administration of nitroglycerine was 5.61± 4.17
minutes. Conclusions: Our study concludes that the drug administered phase can be reduced to 12±3 minutes.