3. Vasovagal Syncope, Tilt Testing

The response to tilt training was compared in a group of 156 patients below 35 years of age (Group A: mean age 19.4 ± 7.2 min 6.5, max 34) to a group of 32 patients above 65 years of age (Group B: mean age 73.2 ± 4.2, min 65 max 81). Patients were submitted to daily tilt testing (60 ° inclination). The efficacy of tilt training was assessed by calculating the number of the first negative test. The diagnostic tilt test was positive after 20.7 ± 12.9 min in group A vs 22.9 ± 11.9 min in group B (P = 0.38). The first negative tilt test was reached after 2.8 ± 1.3 sessions (95% CL: 2.8 – 3.1, median 2.0) in group A vs 3.4 ± 1.4 (95% CL: 2.9 – 3.9, median 3.0) sessions for group B (P = 0.02). Conclusion Tilt training restores orthostatic tolerance in both groups, but it requires more tilt training sessions to become tilt negative in older patients. This could be the result of decreased baroreflex sensitivity with increasing age.