Aim: To evaluate safety and tolerability of Tilt Testing (TT) and Carotid Sinus Massage (CSM) in the oldest old (patients aged 80 and older) and in younger patients with unexplained syncope.
Methods: 1170 patients were enrolled: 549 were 80 or older and 621 were younger. TT and CSM were performed according to the European Society of Cardiology Guidelines. Complications were recorded in each group. An early interruption of TT was defined intolerance and considered as non-diagnostic.
Results: TT complications were observed in 5.3% of older patients and in 2.4% of the younger ones (p=0.01). Most of the complications (88.6%) were minor, as persistent hypotension. Orthostatic hypotension was a predictor of complications. No complications occurred after CSM. Intolerance was reported in 2.7% of older patients and 1.1% of the younger ones (p=0.04), mainly because of orthostatic intolerance.
Conclusions: TT complications were more common in older patients, probably due to a higher prevalence of orthostatic hypotension. No complications occurred during CSM and intolerance was very low in each group. TT and CSM are safe and well tolerated in the oldest old.