Universität zu Köln

Thijs, Roland D., Brignole, Michele ORCID: 0000-0002-1845-5607, Falup-Pecurariu, Cristian, Fanciulli, Alessandra, Freeman, Roy ORCID: 0000-0003-3976-6022, Guaraldi, Pietro, Jordan, Jens, Habek, Mario, Hilz, Max, Traon, Anne Pavy-Le, Stankovic, Iva, Struhal, Walter, Sutton, Richard, Wenning, Gregor and Van Dijk, J. Gert (2021). Recommendations for tilt table testing and other provocative cardiovascular autonomic tests in conditions that may cause transient loss of consciousness Consensus statement of the European Federation of Autonomic Societies (EFAS) endorsed by the American Autonomic Society (AAS) and the European Academy of Neurology (EAN). Clin. Auton. Res., 31 (3). S. 369 - 385. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1619-1560

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Abstract

An expert committee was formed to reach consensus on the use of tilt table testing (TTT) in the diagnosis of disorders that may cause transient loss of consciousness (TLOC) and to outline when other provocative cardiovascular autonomic tests are needed. While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous events. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to the performance of (1) additional provocation tests, such as the active standing test, carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO2 or neuro-endocrine tests; and (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Thijs, Roland D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brignole, Michele UNSPECIFIED orcid.org/0000-0002-1845-5607 UNSPECIFIED Falup-Pecurariu, Cristian UNSPECIFIED UNSPECIFIED UNSPECIFIED Fanciulli, Alessandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Freeman, Roy UNSPECIFIED orcid.org/0000-0003-3976-6022 UNSPECIFIED Guaraldi, Pietro UNSPECIFIED UNSPECIFIED UNSPECIFIED Jordan, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Habek, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Hilz, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Traon, Anne Pavy-Le UNSPECIFIED UNSPECIFIED UNSPECIFIED Stankovic, Iva UNSPECIFIED UNSPECIFIED UNSPECIFIED Struhal, Walter UNSPECIFIED UNSPECIFIED UNSPECIFIED Sutton, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Wenning, Gregor UNSPECIFIED UNSPECIFIED UNSPECIFIED Van Dijk, J. Gert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-605498
DOI:	10.1007/s10286-020-00738-6
Journal or Publication Title:	Clin. Auton. Res.
Volume:	31
Number:	3
Page Range:	S. 369 - 385
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1619-1560
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEAD-UP TILT; CAROTID-SINUS MASSAGE; PSYCHOGENIC NONEPILEPTIC SEIZURES; DELAYED ORTHOSTATIC HYPOTENSION; VASOVAGAL SYNCOPE; BLOOD-PRESSURE; FOLLOW-UP; DIAGNOSIS; COMPLICATIONS; RESPONSES Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60549