Tilt test yields hypotensive susceptibility not diagnosis

What is it about?

The literature shows that tilt testing has high sensitivity and specificity in known fainters and non-fainters but it is not valuable in syncope in heart disease. In parallel tilt predicts syncope recurrence in paced patients with carotid sinus syndrome and vasovagal syncope (older patients). Thus, it should now be considered a risk stratification tool rather than diagnostic.

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Why is it important?

In Vasovagal syncope of older patients, tilt should not be considered a diagnostic test but only indicating the extent of hypotension in a recurrent attack. Thus, in this condition, it should be viewed as a risk stratification tool to inform the likelihood of pacing success in control of further syncope.