What is a tilt table exam?
The tilt table is a diagnostic test to evaluate syncope or fainting. In the past, patients who experience syncope were subjected to long, involved, expensive tests that were difficult to interpret effectively. Today, we know that many syncopal episodes are due to a syndrome called transient autonomic dysfunction, or neuro-cardiogenic syncope. This syndrome causes a sudden drop in blood pressure (hypotension) and a slow heart rate (bradycardia) when body position changes suddenly. Some, but not all of the time, these heart rate and blood pressure changes cause fainting or syncope.
Preparing for the procedure
No special preparation is necessary. Your Inova physician may advise you to stop taking certain medications. If you are an outpatient, you will be asked to put on a hospital gown.
During the procedure
You will be brought to the Electrophysiology Laboratory. EKG patches will be put on your chest and abdomen, and a blood pressure cuff will be placed on your arm to monitor your heart rate and blood pressure.
Tilt table testing begins with the patient lying down on a table. The table is slowly tilted upright. With the position change, normal compensatory processes are mediated in our nervous system. In other words, pulse and blood pressure increase and adapt to the position change. With a positive tilt table test, the blood pressure suddenly drops and is followed by a drop in heart rate. At times, a loss of consciousness occurs as well.
After the procedure
You can resume normal activities, and your Inova physician will inform you about the results of the test and recommended treatments. Treatment for recurrent syncope is tailored to the patient's individuals needs and history. If a positive tilt test confirms transient autonomic dysfunction, the individual may merely need to be educated on lifestyle changes that contribute to the problem. These include avoiding exposure to heat/hot weather and preventing dehydration. Medication is only required when syncopal episodes are recurrent.