A tilt table test is a procedure used to help determine the cause of someone with syncope (passing out episodes).
It is used to test for an abnormal reflex that is present in some people which causes either a slow heart rate, a sudden drop in blood pressure, or both at a time when the heart rate and blood pressure should both be rising. There are multiple names for this type of syncope including vasovagal syncope, vagally-mediated syncope, neurocardiogenic syncope, and vasodepressor syncope. This type of syncope is suspected in people with a structurally normal heart and a history of multiple episodes of passing out in the setting of prolonged standing, dehydration, when having blood drawn, or during pain.
The tilt table test can be a helpful way to confirm the diagnosis of vasovagal syncope or help determine if treatment is adequate.
The Program
Before the Procedure
You will be told not to eat or drink anything after midnight on the night before the procedure. Follow your physicians’ instructions for taking medications the morning of the tilt table test.
The Tilt Table Test
The tilt table test is typically performed in the hospital setting with an intravenous in place and constant monitoring of the heart rhythm and heart rate as well as the blood pressure. You will be asked to lie down on a table on your back. You will be strapped to the table to prevent you from falling off should you get dizzy or pass out during the test. A baseline set of vital signs (heart rate and blood pressure) as well as an electrocardiogram will be performed. At the start of the test the table will be tilted up at an angle of 60 or 70 degrees. Depending on the protocol used, the table will remain this way for anywhere from a few minutes to 30 minutes. Your vital signs will be constantly monitored by the staff throughout the test. You will be asked not to speak throughout the test unless you develop any symptoms such as lightheadedness, sweating, nausea, or dizziness. If after a certain amount of time you have not developed any symptoms it is possible that a medication will be injected or infused into the intravenous. If you still have not developed any symptoms then you will be returned to the flat position and the test will be terminated. If at any point during the test you develop any symptoms you should notify the staff performing the test. If your blood pressure or heart rate drops significantly the test will be terminated.
After the Procedure
You will be returned to the flat position at the end of the test and given a few minutes to recover. Once your vital signs are stable the intravenous will be removed. You will be able to eat whenever the test is finished. The results of the test will be made available to you right away.
Risks
There are few risks to a tilt table test. There is the possibility that you will pass out during the test but since you are in a monitored setting with an intravenous in place, the risk is minimal. You should speak with your physician regarding these risks and understand them prior to undergoing the test.