Before you start the tilt table test, a member of your health care team will do the following to prepare you for the test:
- Place sticky patches (electrodes) on your chest, legs and arms. The electrodes are connected by wires to an electrocardiogram (ECG or EKG) machine that monitors your heart rate.
- Place a blood pressure monitor or cuff on your finger, on your arm or on both to check your blood pressure during the tilt table test.
- If needed, place an intravenous (IV) line into a vein in your arm for delivering medication during the second part of the test.
During a tilt table test
For the test, you lie down on a table that can be moved from a horizontal to a vertical position. The table has a footrest and safety belts. The belts are placed around your body during the test to help ensure that you don't slip off the table. Once you're positioned on the table, the test progresses this way:
- Your heart rate and blood pressure are monitored for about five minutes while you're lying flat (horizontal).
- The bed is then moved to a vertical position (about a 60- to 90-degree angle) so that you are in a head-up position.
- Depending on the reason for the tilt table test, you may stay in the vertical position for about five to 10 minutes, or you may remain in the vertical position for up to 45 minutes.
- While you are in the vertical position, you remain as still as possible. During the test, if you feel signs and symptoms such as nausea, sweating, lightheadedness or irregular heartbeats, tell a member of your health care team.
If you don't faint or experience any other symptoms after 45 minutes, the medication isoproterenol (Isuprel) may be given through an IV line.
This medication lowers your diastolic blood pressure (the bottom number in a blood pressure reading), lowers peripheral vascular resistance, increases your heart rate and may prompt the abnormal nervous system reflex that causes vasovagal or neurocardiogenic syncope.
- You then remain in the upright position and are monitored for another 15 to 20 minutes.
After a tilt table test
If you faint at any time during the test while you're in the vertical position, the table is returned to a horizontal position immediately, and you're monitored closely. Most people regain consciousness almost immediately.
In some cases, if blood pressure and heart rate changes indicate you are about to faint, the table is returned to a horizontal position, and you may not actually lose consciousness.
When your tilt table test is complete, you may return to your normal activities for the remainder of the day.
March 24, 2015
- Hatoum T, et al. A practical approach to investigation of syncope. Canadian Journal of Cardiology. 2014;30:671.
- Tilt table testing. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/cardiovascular_disorders/cardiovascular_tests_and_procedures/tilt_table_testing.html. Accessed Jan. 28, 2015.
- Olshansky B. Upright tilt table testing in the evaluation of syncope. http://www.uptodate.com/index. Accessed Jan. 28, 2015.
- Heart test. Heart Rhythm Society. http://www.hrsonline.org/Patient-Resources/Symptoms-Diagnosis/Heart-Test. Accessed Jan. 28, 2015.
- Rea RF (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 10, 2015.