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Journal of Zhejiang University SCIENCE B 2005 Vol.6 No.4 P.304-306

http://doi.org/10.1631/jzus.2005.B0304


Serious response during tilt-table test in elderly and its prophylactic management


Author(s):  HAN Yang, LI Xiao-xia, JIANG Wei-li, WANG Zhao-di, CHEN Tian-zhi

Affiliation(s):  First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   Hanyang1088@hotmail.com, lxx1021@sina.com

Key Words:  Tilt-table test (TTT), Vasovagal syncope (VVS), Serious response, Prophylactic management


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HAN Yang, LI Xiao-xia, JIANG Wei-li, WANG Zhao-di, CHEN Tian-zhi. Serious response during tilt-table test in elderly and its prophylactic management[J]. Journal of Zhejiang University Science B, 2005, 6(4): 304-306.

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author="HAN Yang, LI Xiao-xia, JIANG Wei-li, WANG Zhao-di, CHEN Tian-zhi",
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volume="6",
number="4",
pages="304-306",
year="2005",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2005.B0304"
}

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%T Serious response during tilt-table test in elderly and its prophylactic management
%A HAN Yang
%A LI Xiao-xia
%A JIANG Wei-li
%A WANG Zhao-di
%A CHEN Tian-zhi
%J Journal of Zhejiang University SCIENCE B
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%P 304-306
%@ 1673-1581
%D 2005
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2005.B0304

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T1 - Serious response during tilt-table test in elderly and its prophylactic management
A1 - HAN Yang
A1 - LI Xiao-xia
A1 - JIANG Wei-li
A1 - WANG Zhao-di
A1 - CHEN Tian-zhi
J0 - Journal of Zhejiang University Science B
VL - 6
IS - 4
SP - 304
EP - 306
%@ 1673-1581
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.2005.B0304


Abstract: 
Objective: To evaluate the serious response during tilt-table test (TTT) and its prophylactic management. Method: Seventy-six elderly patients were tested at a tilt angle of 70 degrees for a maximum of 45 min and then subjected to isoproterenol-provocative tilt testing. ECG and blood pressure were monitored during the test and patients were kept at normal saline condition through a peripheral intravenous duct. Results: Fifty-one of 76 patients were defined as positive including 23 having serious response; 6 of the 23 patients had arteriosclerosis involving internal carotid arteries and 7 cases had bradycardia, two of which were associated with II°-I A-V block and the others with chronic atrial fibrillation. The serious response consisted of cardiac arrest for more than 5 s (6 cases), or serious bradycardia for more than 1 min (7 cases) or serious hypotension for more than 1 min (10 cases). Those with serious response were managed by returning to supine position, thus driving up legs and intravenous atropine, CPR (2 cases with cardiac arrest) and needing oxygen supplementation (11 cases). Only 2 hypotension patients recovered gradually by 10 min after emergency management, while others recovered rapidly with no complications. Conclusion: Although non-invasive, TTT may result in serious response, especially in elderly. Therefore proper patient selection, control of isoproterenol infusion and close observation of vital signs are decisive for a safe consequence.

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Reference

[1] Ge, W., Lu, L.J., Jiang, W.L., Han, Y., Chen, T.Z., 2000. The prevention and nursing of severe reaction during the straight and slope test. Journal of Nurses Training, 15(2):135-136 (in Chinese with English abstract).

[2] Grubb, B.P., Kosinski, D., 1997. Neurocardiogenic syncope and related syndromes of orthostatic intolerance. Cardiology in Review, 5:182-189.

[3] Li, Y.F., Hu, D.Y., Yang, M., Yang, L., Wang, J.N., 1994. Methodology evaluation of tilt table test diagnosis syncope. Chinese Cardiovascular Disease Journal, 22:181 (in Chinese).

[4] Ren, Z.W., Wu, N., Chen, M.Y., Li, J.C., Hu, D.Y., Guo, L.N., Huang, C.X., Huang, D.J., Jiang, W.P., 1998. Suggestion of tilt table test for diagnosis of vasovagal syncope. Chin J Cardio, 26(5):325-327 (in Chinese).

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