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題名 | Application of Head-up Tilt Table Testing in Children |
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作 者 | Lai, Wei-ting; Chen, Ming-ren; Lin, Shan-miao; Hwang, Haw-kwei; | 書刊名 | Journal of the Formosan Medical Association |
卷期 | 109:9 2010.09[民99.09] |
頁次 | 頁641-646 |
分類號 | 415.932 |
關鍵詞 | Children; Neurocardiogenic syncope; Tilt table testing; |
語文 | 英文(English) |
英文摘要 | Background/Purpose We investigated the application of head-up tilt table testing (HUT) and management of neurocardiogenic syncope (NCS) in children, as pediatric studies are limited. Methods Seventy-nine patients (ages 6-18 years) underwent HUT for evaluation of syncope. Patient triggers and premonitory symptoms allowed the clinical diagnosis of NCS or non-NCS. Results were divided into four hemodynamic types (1, 2A, 2B, and 3) according to patient response to HUT. Results NCS occurred in 65 patients and non-NCS in 14 patients. Isoproterenol infusion significantly increased the sensitivity of the test (from 28% to 45%) and was associated with a slight decrease in the specificity (from 93% to 86%). Subjects in the type 1 group accounted for the majority of responses to the test (69%). There were no complications associated with the test. At follow-up (16.6 ± 9.3 months), the overall recurrence rate was 30.8% but NCS was less severe in most patients. The recurrence rate was similar for patients with a positive or negative HUT and for both pharmacologically and non-pharmacologically treated patients. Conclusion HUT can be safely performed with a high specificity in children, with the sensitivity of HUT improved by isoproterenol. Therefore, a positive response to treatment is reassuring to the physician and family. NCS is generally a self-limited condition despite a high recurrence rate. |
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