Tilt Table Test in Children with Unexplained Syncope

Background: Neurocardiogenic syncope is well known as the most frequent cause of syncope in childhood. The head-up tilt table test (HUTT) is now widely used to evaluate patients with unexplained syncope. Although many reports have reported on children associated with neurocardiogenic syncope, the relationship between the clinical characteristics of those patients and the results of the HUTT remains to be clarified. We therefore studied the children with unexplained syncope who underwent a tilt table test at our institution, to determine their clinical characteristics and the HUTT results. Methods: From July 2001 to March 2006, a total of 17 pediatric patients with unexplained presyncope and syncope that underwent a HUTT at our institution were included. We divided those patients into two groups: Group 1 included five children who had a positive tilt table test, and Group 2 included 12 children who had a negative tilt table test. We compared the demographic, clinical and laboratory data between the two groups. Results: There were no significant differences regarding the age, sex, syncopal episodes or duration of the syncopal history between the two groups. The children with a positive HUTT response often had predisposing factors of syncope and experienced prodromes (5/5 vs. 3/12, p＜0.05). A mixed hemodynamic response predominated (80%) in our positive tilt patients. Conclusion: We concluded that the presence of predisposing factors or prodromes of syncope was closely associated with a positive HUTT.