Significant complications can occur with ischemic heart disease and tilt table testing

We present an elderly patient who had syncope, with known coronary artery d isease and a conduction abnormality. Because of a possible vasovagal reacti on, the patient underwent a tilt table test prior to evaluation of ischemia or her LV function. During the tilt table test on isoproterenol, the patie nt developed ventricular fibrillation which was corrected immediately by ca rdioversion. Subsequently, the patient was found to have significant corona ry artery disease which was treated with stenting and angioplasty. After tr eatment, there were no inducible arrhythmias on full dose isoproterenol. Th is case reports a significant complication that may occur when tilt table t esting with isoproterenol and ischemia.