Usefulness of tilt training in patients with neurocardiogenic syncope

Neurocardiogenic syncope is a relatively common cause of syncope and is diagnosed by a head-up tilt test. A wide variety of medical treatments has been proposed, such as beta-blocker, vasoconstrictor, fludrocortisone, and serotonin re-uptake inhibitors. However, there are some cases in which these therapies have failed to prevent syncope. A recent report has shown that tilt training is a very effective therapy for recurrent neurocardiogenic syncope. Therefore, in order to determine whether tilt training could prevent symptoms in the patients with recurrent neurocardiogenic syncope, this study was undertaken. Five patients diagnosed with neurocardiogenic syncope by head-up tilt test were included. During hospital admission, they were tilted daily until a negative response occurred. Negative responses were noted in four patients. However, tilt training was discontinued in one patient due to lack of response. Following discharge, the four patients performed tilt training at home by leaning against a wall. They were interviewed on the phone eight to eleven months later and they have not experienced any symptoms during the follow-up period. This is the first domestic report of tilt training in patients with neurocardiogenic syncope.( ( ( (Korean Circulation J 2001;31(8 :801-808