Positive head-up tilt table test in patients with the long QT syndrome
Open accessAbstract
Aims Syncope in patients with the long QT syndrome is commonly attributed to a ventricular arrhythmia (torsades de pointes). The susceptibility of patients with the long QT syndrome (LQTS) to neurally mediated syncope is currently unknown. Methods and results Head-up tilt table testing (70 degrees) was performed in six patients with the long QT syndrome and a history of syncope. All patients had syncope with a mixed response. The RR interval was significantly decreased 2 min before the onset of syncope (980 +/- 125 ms vs 630 +/- 91 ms, P=0.003), and significantly increased during syncope (983.17 +/- 224.71; P=0.006). Non-significant changes in QT intervals were observed. Baseline QT was 513 +/- 86 ms and decreased to 450 +/- 59 ms 2 min before the onset of syncope (P=0.11). Although not statistically significant, QT intervals during syncope were longer than at 2 min before syncope (485 +/- 85 ms vs 450 +/- 59 ms; P=0.29). Conclusion Our results suggest that patients with the LQTS are susceptible to neurally mediated syncope. Whether this susceptibility differs from control populations remains unresolved. From a clinical standpoint, neurocardiogenic syncope should be considered a diagnostic alternative in patients with LQTS.
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In the pediatric population, significant overlap exists in the clinical presentation of patients with VVS and arrhythmic syncope.
“This is particularly true in the pediatric population, where significant overlap exists in the clinical presentation of patients with VVS and arrhythmic syncope (313,314).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [313]
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- Authors
- Hermosillo, A.
- Affiliations
- Instituto Nacional de Cardiología (MX)
- Corresponding author
- Hermosillo, A
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 1999-10
- Volume
- 1
- Issue
- 4
- Pages
- 213-217
- ISSN
- 1099-5129 (ISSN-L)
- OpenAlex
- W2100733891
- Cited by
- 21
- References
- 15
- Citations by year
- 2021: 1 · 2020: 2 · 2017: 4 · 2016: 1 · 2015: 1 · 2013: 2
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- long QT syndrome, neurally mediated syncope, vasovagal syncope, tilt table test, syncope, QT interval, RR interval, torsades de pointes, ventricular arrhythmias
- MeSH terms
- Adolescent, Child, Female, Hemodynamics, Humans, Long QT Syndrome, Male, Middle Aged, Tilt-Table Test, Syncope, Vasovagal
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