Tilt Table Procedure

Heart Procedures - Tilt Table Procedure

(Upright Tilt Testing)

Procedure overview

What is a tilt table procedure?

A tilt table procedure is a diagnostic procedure that may be used to evaluate a person who has symptoms of syncope (fainting). When a person has a complaint of syncope, the physician will carefully evaluate the person's past medical history and perform a physical examination. If basic components of the examination or history do not reveal a potential cause for the syncope, and the person has no history of heart disease, then further diagnostic procedures may be scheduled.

Syncope, or fainting, may be caused by various medical problems. Syncope may occur rarely to frequently, depending on the cause. Some causes of syncope may include, but are not limited to, the following:

One type of diagnostic procedure that may be used to assess syncope is the tilt table procedure. This procedure attempts to cause syncope by creating changes in posture from lying to standing. This test is performed by having the patient lie flat on a special bed or table with safety belts and a footrest while connected to electrocardiogram (ECG) and blood pressure monitors. The bed or table is then elevated to an almost standing position (60 to 80 degree vertical angle) to simulate the patient standing up from a lying position. The blood pressure and ECG are measured during the test to evaluate changes during the position changes. If the test causes an episode of syncope, then the cause of the syncope is vasovagal syndrome. The physician can then prescribe specific treatment for the syncope once the cause is known.

Other related procedures that may be used to assess the heart include resting or exercise electrocardiogram (ECG), Holter monitor, cardiac catheterization, chest X-ray, computed tomography (CT scan) of the chest, echocardiography, electrophysiological studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, signal-averaged electrocardiogram, and cardiac CT scan. Please see these procedures for additional information.

Reasons for the procedure

A physician may order a tilt table procedure if recurring episodes of syncope (fainting) occur that have had certain other causes ruled out by other tests.

There may be other reasons for your physician to recommend a tilt table procedure.

Risks of the procedure

Possible risks of tilt table testing include, but are not limited to, the following:

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Before the procedure

During the procedure

A tilt table procedure may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician’s practices.

Generally, a tilt table procedure follows this process:

  1. You will be asked to remove any jewelry or other objects that may interfere with the procedure.
  2. You will be asked to remove clothing from the waist up and will be given a gown to wear.
  3. You will be asked to empty your bladder prior to the procedure.
  4. You will lie down on a special bed or table.
  5. An IV line may be started in your hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed.
  6. ECG electrodes will be placed on your chest and attached to an ECG machine with wire leads. A blood pressure cuff will be placed on your arm and will be attached to an automatic blood pressure monitoring machine.
  7. You will lie flat on the bed initially, then you will be raised to an almost standing angle while on the bed. Straps will be placed across your chest and legs to keep you from falling if you faint during the procedure.
  8. You will remain upright for up to 45 minutes to determine if symptoms such as dizziness, fainting, low heart rate, and/or a low blood pressure occur.
  9. If no symptoms occur, you may be given a medication in your IV to speed up your heart rate. This will be given while you are lying flat again.
  10. After the medication is given (if needed), you will again be tilted upright and monitored for symptoms of dizziness, fainting, low heart rate, and/or a low blood pressure.
  11. Once adequate data has been obtained, you will be lowered to a flat position and allowed to rest for a while. Your heart rate and blood pressure will be monitored.
  12. When you are stable, the IV line, blood pressure cuff, and ECG electrodes will be removed.
  13. You will be allowed to dress and leave, unless your physician instructs you differently.

After the procedure

You should be able to resume your normal diet and activities, unless your physician instructs you differently.

Generally, there is no special care following a tilt table procedure.

Notify your physician if you develop any signs or symptoms you had prior to the test (e.g., dizziness or fainting).

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American College of Cardiology

American Heart Association

National Heart, Lung, and Blood Institute (NHLBI)

National Institutes of Health (NIH)

National Library of Medicine

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Online Resources of Heart Center

 

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