Sagristà-Sauleda J, Romero B, Permanyer-Miralda G, Moya A, Rius-Gelabert T, Mont Girbau L, Soler-Soler J
Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Europace. 1999 Jan;1(1):63-8. doi: 10.1053/eupc.1998.0015.
Head-up tilt test was performed in 99 patients with syncope of unknown origin and intraventricular conduction defect. Twenty-five per cent had a positive response to tilt with reproduction of spontaneous clinical symptoms. Holter recording revealed paroxysmal atrioventricular (AV) block in three patients. Carotid sinus massage was positive in four patients. An electrophysiological study was performed in 76 patients with abnormal findings in 17 (22%). Thus, vasovagal syncope was the discharge diagnosis in 25 patients (25%). Therefore, tilt test should be considered in patients with intraventricular conduction defect presenting with syncope of unknown origin, especially if clinical findings suggest the possibility of a vasovagal mechanism, or if the results of the electrophysiological study are inconclusive.
对99例不明原因晕厥且伴有室内传导阻滞的患者进行了直立倾斜试验。25%的患者倾斜试验呈阳性反应，且再现了自发临床症状。动态心电图记录显示3例患者有阵发性房室传导阻滞。4例患者颈动脉窦按摩阳性。对76例有异常发现的患者进行了电生理研究，其中17例（22%）有异常。因此，25例患者（25%）的出院诊断为血管迷走性晕厥。因此，对于不明原因晕厥且伴有室内传导阻滞的患者，尤其是临床检查结果提示血管迷走机制可能性或电生理研究结果不确定时，应考虑进行倾斜试验。
