The Tilt table test (also known as a passive head-up tilt test or head upright tilt test) is a test used to investigate the cause of recurrent blackouts (also called syncope) suspected to be due to Vasovagal syncope.
What is Vasovagal Syncope?
- Syncope (pronounced “sin-ko-pea”) is the brief loss of consciousness and posture caused by a temporary decrease in blood flow to the brain.
- Vasovagal syncope occurs when the part of your nervous system that controls blood pressure and heart rate suddenly lowers your heart rate and blood pressure rapidly for a short duration of time. Blood flow to your brain is transiently diminished and you may faint.
- The person usually regains consciousness and becomes alert right away, but may experience a brief period of confusion.
What are the benefits of a tilt table test?
- The results of this test will help your doctor determine what may be causing your symptoms of light-headedness or fainting spells.
- The tilt table test results will help determine if other tests may be needed to help diagnose your condition. The test results also may be used to evaluate heart rhythm, blood pressure and sometimes other measurements with changes in position.
- The test results will help your doctor plan a course of treatment which may include simple positional or exercise techniques to reduce the incidence of fainting, medications or pacemaker implantation in certain clinical scenarios.
Who will benefit from this test?
- Patients with recurrent unexplained fainting spells.
- Patients with a single fainting spell and work in high-risk occupations (eg. pilots)
How to prepare for the test
- Please take your regular medications as prescribed.
- If you have questions or need help making adjustments to your medications, please call our clinic and speak to our doctor.
- Do not discontinue any medication without first talking to our doctor.
- Fasting for the test
- Do not eat or drink anything except for small amounts of water for at least 4 hours before your test.
- Consume your regular medications with small sips of water only.
- Dress code
- Wear comfortable clothes and shoes.
How is the test performed?
Before the test
- Tilt-Table : You will lie on a tilt-table with soft Velcro straps placed across your body to secure you when the table is tilted during the test.
- Intravenous (IV) line placement : A small bore IV line will be placed into a vein in your arm for delivering medications during the second part of the test if needed.
- Blood pressure (BP) cuffs will be placed around both arms and attached to monitors to measure your BP during the test.
- Electrodes (small, sticky patches) will be placed on your chest and connected to an ECG monitor. This allows continuous recording of heart rate and rhythm during the test.
During the test
- While lying supine, your heart rate and blood pressure response will monitored closely while the table is tilted in a head-up position at different levels. You will always be tilted upright so your head is above your feet; you will never be tilted upside-down.
- Throughout the test, the nurse or technician will ask you how you feel. You may not have any symptoms, or you may experience pre-syncope symptoms (called premonitory symptoms), such as light-headedness, dizziness, nausea, palpitations (fluttering in the chest) or blurred vision.
- The purpose of the test is not to make you faint, although fainting may occur. If this happens, the table will be put back to the flat position immediately.
- Your blood pressure, heart rate and ECG will be constantly monitored throughout the test and together with your symptoms, will help our doctor diagnose the underlying cause of your condition.
After the Test
- The tilt table will be lowered to a flat position and you will be observed for 5-10 minutes as your BP, heart rate and ECG are recorded.
- You will be monitored for another 15-20 minutes after completion of the test, or until all the symptoms you may have experienced during the test have resolved.
- The IV line will be removed after the test. Bruising and swelling at the IV site are common reactions and will subside with time.
- Duration of the test: This test takes about 60-90 minutes to complete but it may be shorter depending on the changes observed in your BP and heart rate.
- Going home after the test: Though you will usually be able to go home independently after the test, we recommend that you have someone accompany you home after the test.
How does the doctor use this test to manage my condition?
Positive Tilt table Test
This means that you have a condition that causes an abnormal change in your blood pressure and heart rate known as Vasovagal syncope. Our doctor will plan a course of treatment which may include simple positional or exercise techniques to reduce the incidence of fainting, medications or pacemaker implantation in certain clinical scenarios.
Negative Tilt table Test
This means you are unlikely to have Vasovagal syncope and our doctor will discuss with you further tests to exclude other causes of fainting.
1. British Heart Foundation – Your guide to tilt test