Kalhor Parvin, Ghahari Parichehr, Asgari Nader, Jalali Arash, Sadeghian Saeed
Cardiovascular Diseases Research Institute, Tehran Heart Center Tehran University of Medical Sciences Tehran Iran.
Doctor of Medicine Tehran University of Medical Sciences Tehran Iran.
J Arrhythm. 2025 Sep 25;41(5):e70190. doi: 10.1002/joa3.70190. eCollection 2025 Oct.
The head-up tilt test (HUTT) has been markedly changed over the years, especially in the specified time for the passive and active phases. However, a consensus-based protocol has yet to be established.
Seven hundred twenty-four patients suspected of vasovagal syncope who underwent HUTT through one of the protocols of 15to 20-min testing for each active/passive phase (the whole test duration was 30 or 40 min, respectively) were evaluated. Then, the positive responses were recorded.
470 (64.9%) and 254 (35.1%) patients in the 15- and 20-min groups, respectively. Overall, 238 patients (50.6%) in the 15-min group and 140 patients (55.1%) in the 20-min group had positive responses ( = 0.25). There was no significant difference in the number of positive responses between the 15- and 20-min groups in any of the passive ( = 0.53) and active ( = 0.3) phases.
The 15-min HUTT protocol has similar results to the 20-min protocol. Saving 10 min for each test has several potential benefits, such as increasing patient acceptance, decreasing patient discomfort, and enabling the conduct of more tests in a day in a syncope unit.