Original scientific paper

Tilt-table test in patients with convulsive syncope

Marko Mornar Jelavić ; Zagreb-East Health Center, Department for Internal Medicine and dialysis, Zagreb, Croatia
Hrvoje Hećimović ; Sestre milosrdnice University Hospital Center, Department of Neurology, Zagreb
Vesna Erceg ; Sestre milosrdnice University Hospital Center, Zagreb, Department of Cardiology
Željko Plazonić ; University Hospiatal Center Rijeka, Cardiac Catheterisation Laboratory, Department of Cardiology, Rijeka, Croatia
Hrvoje Pintarić ; Sestre milosrdnice University Hospital Center, Cardiac Catheterisation Laboratory, Department of Cardiology, Zagreb
Jadranko Turčinov ; General Hospital Zadar, Department of internal diseases

Abstract

Aim: To investigate the role of head-up tilt-test (HUTT) in evaluation of patients with convulsive syncope, especially of those resistant on antiepileptic drugs.
Patients and methods: This retrospective study (February 2012 – September 2014) was performed on 30 consecutive patients at the Department of Cardiology, Sestre milosrdnice University Hospital Center. They were grouped as follows: Group A (convulsive syncope resistant on antiepileptics, n = 12) and Group B (convulsive syncope with no medications, n = 18). The groups were analysed by their demographic data (age, gender), referral specialists (cardiologists, neurologists, others) and HUTT results (positive/negative) with specific response (cardioinhibitory, vasodepressor, or mixed).
Results: Groups A and B were referred to the HUTT only by neurologists (p < 0.05). 5 patients were positive (16.7%). In Group A, 3 patients (60.0%) had cardioinhibitory response, while 2 patients in Group B had mixed (20.0%) and vasodepressor (20.0%) response.
All three patients (2 male/1 female, mean age 28.5 years) in Group A with cardioinhibitory response had normal electroencephalography and were on antiepileptics. During HUTT, they had bradycardia (heart rate 30.0 ± 5.0 beats/min) and prolonged asystole (13.7 ± 11.0 seconds) with development of typical convulsions. They got a permanent pacemaker (atrial/ventricular stimulation, heart rate control) and anticonvulsive therapy was slowly withdrawn. They had no syncope recurrence during 24 months of follow-up.
Conclusion: HUTT has an important role in the evaluation of patients with convulsive syncope resistant on anticonvulsive drugs. Indication for a pacemaker implantation proved to be effective in preventing syncope relapses in these patients.

Keywords

cardioinhibitory syncope; seizures; tipt-up table test; permanent pacemaker; epilepsy

Hrčak ID:

159829

URI

https://hrcak.srce.hr/159829

Publication date:

7.6.2016.

Article data in other languages: croatian

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