Head Upright Tilt Table

What is a head upright tilt table test?

A head up tilt table testing is a safe, non-invasive test to evaluate patients who are suspected of having a common cause of syncope known as neurocardiogenic syncope.

How is a head up right tilt table test performed?

This test is done in the hospital.  An intravenous line (IV) is placed and then the patient is placed on a specialized table called a tilt table.  The patient lies on their back and is comfortably secured to the table for their protection.  The table is then tilted so that the head of the table is raised from zero to 70 degrees. The patient is then observed closely  with frequent blood pressure readings and continuous heart rate recordings.  The patent may remain in this upright position for 30-40 minutes.  If the patient is stable and has no symptoms, then the patient may be given a sublingual nitroglycerine to see if this will trigger a fainting spell.  The patient is then observed for another 10-15 minutes. 

What is a positive head upright tilt table test?

During this test, the patient may experience a drop in both their blood pressure and heart rate.  The combination of low blood pressure and a slow heart rate may cause the patient to faint.  This combination of findings would confirm the diagnosis of neurocardiogenic syncope.

What are the potential complications of this test?

This is a very safe test and the risk of any serious complications is less than 1 in 100.  We prevent injury to the patient who faint by having all patients secured to the table with large straps.  Once the patient faints, the head of the table is lowered back down and patients quickly regain consciousness.  The blood pressure and heart rate also return to normal very quickly.

What is the recovery from this test?

Most commonly, the patient can go home about one hour after the test and can drive themselves. If nitroglycerin is used during the test, headache and lightheadedness may be experienced. Tylenol can be helpful for the headache. Otherwise, no significant complications are expected from this test.