Journal Article

Positive head-up tilt table test in patients with the long QT syndrome

A.G. Hermosillo, J.C. Falcón, M.F. Márquez, D. Arteaga and M. Cárdenas

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 1, issue 4, pages 213-217
Published in print October 1999 | ISSN: 1099-5129
Published online October 1999 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1053/eupc.1999.0056
Positive head-up tilt table test in patients with the long QT syndrome

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Aims

Syncope in patients with the long QT syndrome is commonly attributed to a ventricular arrhythmia (torsades de pointes). The susceptibility of patients with the long QT syndrome (LQTS) to neurally mediated syncope is currently unknown.

Methods and Results

Head-up tilt table testing (70°) was performed in six patients with the long QT syndrome and a history of syncope. All patients had syncope with a mixed response. The RR interval was significantly decreased 2 min before the onset of syncope (980±125 ms vs 630±91 ms, P=0·003), and significantly increased during syncope (983·17±224·71;P=0·006). Non-significant changes in QT intervals were observed. Baseline QT was 513±86 ms and decreased to 450±59 ms 2 min before the onset of syncope (P=0·11). Although not statistically significant, QT intervals during syncope were longer than at 2 min before syncope (485±85 ms vs 450±59 ms;P=0·29).

Conclusion

Our results suggest that patients with the LQTS are susceptible to neurally mediated syncope. Whether this susceptibility differs from control populations remains unresolved. From a clinical standpoint, neurocardiogenic syncope should be considered a diagnostic alternative in patients with LQTS.

Keywords: Long QT syndrome; neurally mediated syncope; head-up tilt table testing

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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