Serious responsiveness during tilt table test in the elderly and its prophylactic management / 中华老年医学杂志

ABSTRACT

Objective To summarize the onset and the management of serious responsiveness during the tilt table test (TTT), and the prevention measures. Methods Thirty six elderly patients (26 males and 10 females, aged between 60 70) were tested with a tilt angle of 70 degrees for a maximum of 45 minutes and then processed with isoproterenol provocative tilt testing. ECG and blood pressure were monitored during the test and the peripheral intravenous cannula were maintained for all patients with normal saline. Results Twenty one of the 36 patients were defined as positive including 10 showing serious responsiveness. Of the 10 patients, 3 had a history of atherosclerosis involving internal carotid arteries; among the 3 with bradycardia, 2 were associated with II? A V block, and another one was with chronic atrial fibrillation. The serious reponsiveness included asystole for more than 5 seconds(3 cases) , serious bradycardia for more than 1 minute(3 cases) , and serious hypotension for more than 1 minute (4 case), respectively. Those with serious responsiveness were managed with returning to supine position, or intraveneous atropine, or CPR (2 cases), or oxygen given(4 cases). Only 2 hypotensive patients recovered gradually in 10 minute emergent management while others recovered rapidly and with no complication. Conclusions TTT may result in serious responsiveness especially in elderly patients though it is non invasive method. Therefore, proper patient selection according to the indications, control of isoproterenal infusion and close observation of vital signs are important for a safe consequence.