Short Versus Long Head-up Tilt Test Protocols to Evaluate Vasovagal Syncope in Children
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Tarih
2022
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info:eu-repo/semantics/openAccess
Özet
Objective: Vasovagal syncope is a common clinical problem in children and adolescents, for which the head-up tilt test (HUTT) is the standard diagnostic procedure. In this study, we evaluated sublingual nitroglycerine-stimulated HUTT protocols, comparing the results with passive phases of 20 minutes versus 45 minutes. Method: A total of 293 patients aged 6 to 18 years with a history of recurrent syncope were studied. Physical examination, laboratory parameters, and echocardiographic examination were normal in all. The patients underwent standard HUTT with sublingual nitroglycerin used in the active phase. A short protocol was used for one group (n=143) with a passive phase of 20 minutes, while testing in the others (n=150) comprised a long protocol, with a passive phase of 45 minutes. Results: There were no significant differences between the two groups in terms of age, sex, and length of time between the first syncope and the tilt test. In the short protocol group, HUTT results were positive in 43(30.1%) in the passive phase, 40(28%) in the active phase, and 83(58%) overall, compared with 65(43.3 %), 32(21.3%), and 97(64.7%), respectively, in the long protocol group. Among those in the long protocol group, 26 of 32 (81.5%) who had a positive response in the passive phase developed syncope within the first 20 minutes. Conclusion: The HUTT protocol with a short passive phase has the advantage of saving time while providing results comparable with the long protocol, which might be preferable in children and adolescents.
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11
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1
