Batra Anjan S, Balaji Seshadri
University of California-Irvine, Children's Hospital of Orange County, Orange, CA 92868,
Indian Pacing Electrophysiol J. 2008;8(4):242-6. Epub 2008 Nov 1.
The role of tilt table testing as a diagnostic modality in children with unexplained syncope is unclear. We sent a questionnaire to members of the Pediatric and Congenital Electrophysiology Society to assess the current practice pattern. Of the 186 members, 97 (52%) replied. Twenty four percent of the pediatric electrophysiologists have completely stopped doing tilt table tests and of those performing the tests, a majority (76%) did < 10 tests/yr (median=3 tilts/yr, range 0-100/yr). Of those performing the test, 95% rarely or never accepted direct referrals from the general practioners and 62% felt that the frequency of tilt table tests being performed had decreased since they had started practicing. The median usefulness of the test was rated at 3 (range 1-9) on a scale of 1 to 10 with 10 being very useful. A majority (68%) felt they rarely or never altered treatment based on the results of the tilt test. Wide variability was noted in the test protocol including the tilt angle, tilt duration, use of pharmacologic agents and the duration of fasting prior to the test. We therefore conclude that there is significant lack of standardization in tilt table tests performed in children. Tilt table testing, as perceived by pediatric electrophysiologists, is of limited utility and progressively less used in children with syncope.
倾斜试验作为不明原因晕厥患儿的一种诊断方式，其作用尚不清楚。我们向儿科与先天性电生理学学会的成员发送了一份问卷，以评估当前的实践模式。186名成员中，97名（52%）进行了回复。24%的儿科电生理学家已完全停止进行倾斜试验，在仍在进行该试验的人员中，大多数（76%）每年进行的试验少于10次（中位数为每年3次，范围为0至100次/年）。在进行该试验的人员中，95%很少或从不接受全科医生的直接转诊，62%的人认为自开始执业以来，倾斜试验的执行频率有所下降。在1至10的评分量表上，该试验的中位有用性被评为3分（范围为1至9分，10分为非常有用）。大多数（68%）人认为他们很少或从不根据倾斜试验的结果改变治疗方案。在试验方案中发现了很大的变异性，包括倾斜角度、倾斜持续时间、药物使用以及试验前禁食的持续时间。因此，我们得出结论，儿童倾斜试验存在严重缺乏标准化的情况。在儿科电生理学家看来，倾斜试验的效用有限，在晕厥患儿中使用得越来越少。
