Vol 59, No 8 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
Get Citation

The usefulness of tilt testing with an intravenous beta-blocker in assessing the efficacy of long-term therapy in patients with vasovagal syncope

Grzegorz Gielerak, Karol Makowski, Ewa Dłużniewska, Alicja Stec, Marian Cholewa
Kardiol Pol 2003;59(8):98-102.
Vol 59, No 8 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Although beta blockers are frequently used for the prevention of recurrences of vaso-vagal syncope, the prediction of the long-term efficacy of this treatment is difficult.
Aim: To assess whether the result of tilt testing with an intravenous beta blocker can predict the long-term efficacy of beta blockade.
Methods: The study group consisted of 62 patients (29 females, mean age 32.8±12.3 years and 33 males, mean age 35.9±18.2 years) with at least two syncopal episodes during the six months preceding positive tilt testing. After baseline tilt test, propranolol in a dose of 0.1 mg/kg body weight was administered intravenously and the tilt test was repeated. Beta blockade was defined effective if the second tilt test was negative (complete efficacy) or the time to syncope during tilt testing was increased compared with the baseline tilting (partial efficacy). All patients received chronic propranolol treatment and were followed for one year or till the recurrence of syncope.
Results: Intravenous propranolol prevented (n=33) or delayed (n=18) syncope during tilt testing in 51 (82%) patients whereas it was ineffective in the remaining 11 (18%) patients. During 8.6&#177;6.7 (range 1-14) months of follow-up, 20 (32%) patients had syncope recurrence; 13 (25%) from the group with effective intravenous propranolol versus 7 (64%) patients in whom intravenous propranolol did not prevent syncope during tilt testing (p<0.015). Analysis of survival without a recurrence of syncope revealed a significant relationship between the results of tilt testing with intravenous propranolol and the efficacy of long-term beta-blocker therapy (p<0.003). There were no significant differences between the predictive value of tilt testing with propranolol between patients with complete or partial propranolol efficacy (NS) whereas significant differences between each of these two groups and patients with ineffective intravenous propranolol were noted (p<0.04 and p<0.002, respectively).
Conclusions: Propranolol administered intravenously prevents syncope during tilt testing in a significant proportion of patients. Both complete or partial efficacy of intravenous propranolol predict long-term efficacy of chronic beta blocker therapy in patients with vaso-vagal syncope.

Abstract

Background: Although beta blockers are frequently used for the prevention of recurrences of vaso-vagal syncope, the prediction of the long-term efficacy of this treatment is difficult.
Aim: To assess whether the result of tilt testing with an intravenous beta blocker can predict the long-term efficacy of beta blockade.
Methods: The study group consisted of 62 patients (29 females, mean age 32.8&#177;12.3 years and 33 males, mean age 35.9&#177;18.2 years) with at least two syncopal episodes during the six months preceding positive tilt testing. After baseline tilt test, propranolol in a dose of 0.1 mg/kg body weight was administered intravenously and the tilt test was repeated. Beta blockade was defined effective if the second tilt test was negative (complete efficacy) or the time to syncope during tilt testing was increased compared with the baseline tilting (partial efficacy). All patients received chronic propranolol treatment and were followed for one year or till the recurrence of syncope.
Results: Intravenous propranolol prevented (n=33) or delayed (n=18) syncope during tilt testing in 51 (82%) patients whereas it was ineffective in the remaining 11 (18%) patients. During 8.6&#177;6.7 (range 1-14) months of follow-up, 20 (32%) patients had syncope recurrence; 13 (25%) from the group with effective intravenous propranolol versus 7 (64%) patients in whom intravenous propranolol did not prevent syncope during tilt testing (p<0.015). Analysis of survival without a recurrence of syncope revealed a significant relationship between the results of tilt testing with intravenous propranolol and the efficacy of long-term beta-blocker therapy (p<0.003). There were no significant differences between the predictive value of tilt testing with propranolol between patients with complete or partial propranolol efficacy (NS) whereas significant differences between each of these two groups and patients with ineffective intravenous propranolol were noted (p<0.04 and p<0.002, respectively).
Conclusions: Propranolol administered intravenously prevents syncope during tilt testing in a significant proportion of patients. Both complete or partial efficacy of intravenous propranolol predict long-term efficacy of chronic beta blocker therapy in patients with vaso-vagal syncope.
Get Citation

Keywords

tilt testing - vaso-vagal syncope - beta-blocker

About this article
Title

The usefulness of tilt testing with an intravenous beta-blocker in assessing the efficacy of long-term therapy in patients with vasovagal syncope

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 59, No 8 (2003)

Pages

98-102

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2003;59(8):98-102.

Keywords

tilt testing - vaso-vagal syncope - beta-blocker

Authors

Grzegorz Gielerak
Karol Makowski
Ewa Dłużniewska
Alicja Stec
Marian Cholewa

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl