Electrophysiologic testing in the upright position: Improved evaluation of patients with rhythm disturbances using a tilt table

摘要: Patients are traditionally evaluated in the supine position electrophysiology laboratory, although symptoms due to a cardiac rhythm disturbance often maximal clinically during standing. The assumption of upright results dependent displacement blood, followed by prompt vasoconstriction maintain arterial pressure. This normal response may aggravate tachyarrhythmias increasing catecholamine levels or precipitate vasodepressor syncope if vasoconstrictor is absent. use tilt table electrophysiologic testing was over 12 month period 104 patients having mean age 60 years (range 37 81): 59 with supraventricular tachycardia, 6 vasovagal and 39 carotid sinus hypersensitivity. Twenty-three (22%) had significant abnormalities when that were not present supine: eight tachycardia who their clinical syndromes palpitation reproduced upright, but only minimal supine; two sustained atrioventricular reentry beats six evaluation before typical spells after being placed event seven hypersensitivity massage developing hypotension despite maintaining heart rate pacing (vasodepressor response). In 22% patients, provided important information evident standard position.