RECURRENT UNEXPLAINED SYNCOPE - THE ROLE OF HEAD-UPRIGHT TILT-TABLE TESTING

Recurrent episodes of sudden unexplained syncope are a common complain t of patients referred to health care professionals for evaluation. Tr aditional evaluations are both time consuming and expensive and leave many patients without a diagnosis. Although vasovagally mediated episo des of hypotension and bradycardia have been thought to be a common ca use of unexplained syncope, this was traditionally a diagnosis of excl usion. Head-upright tilt table testing has recently emerged as a valua ble method for confirming the diagnosis of vasovagal syncope and has a llowed a better understanding of this phenomena. This article reviews the pathophysiology of vasovagal syncope. the use of head-upright tilt table testing in its diagnosis, and potential therapies used to preve nt recurrences.