Aim: To verify the diagnostic value of tilt table test (TTT) to predict the efficacy of cardiac pacing (PM) for preventing recurrences of neurally mediated reflex syncope in a selected group of patients with severe clinical presentation and cardio-inhibitory activity documented by implantable loop recorder.
Methods: In this observational and retrospective study we wanted to observe the results of TTT in two groups of treated patients using a PM: with and without recurrences.
Results: We analysed 21 patients. During an average follow-up period of 23+10 months the recurrence of syncope occurred in 5 patients (22%). 16 patients (78%) had not recurrences.
In the group with recurrences TTT was positive in 3 out of four patients in whom the TTT was performed (75%). Among the 16 patients without recurrences TTT was performed in 12 of those and was positive only in 2 cases (16,6%).
Conclusions: A positive TTT response in selected patients treated with PM is more likely correlated with a higher frequency of recurrences of syncope, while a negative response seems to predict the success of the pacing therapy.