Tilt-testing for syncope: when to refer and when it can make a difference


Effectively differentiating between potentially life-threatening causes of syncope and more benign causes requires careful evaluation. Tilt-testing is used variably across cardiovascular units around the world. Its sensitivity and specificity in identifying causes for syncope is debated, yet it can provide important diagnostic information if performed and interpreted skilfully and has a role in guiding therapy. We discuss how it is performed, how to interpret the results, and when it can make a difference to the investigation and treatment of patients with syncope.

Learning objectives

> Explain how to perform a tilt-test and what is involved
> Describe how to interpret the results
> Discuss the indications and appropriate cases to refer
> Explain when it can make a difference in making a diagnosis
> Explain when it can make a difference in guiding therapy


Afzal Sohaib Consultant in Cardiac Electrophysiology & Devices. Bart’s Health NHS Trust, UK
Dr P Boon Lim Cardiologist and Electrophysiologist. Imperial College NHS Trust, UK

Target audience

> General Cardiology
> Electrophysiology
> General Medicine
> General Practice
> Geriatric Medicine

This is an independent Radcliffe production.