Tilt Table Testing

What Is Tilt Table Testing?

A tilt table test is used to evaluate the cause of unexplained fainting (syncope). During a tilt table test, you lie on a table that moves from a horizontal to a vertical position. Your heart rate and blood pressure are monitored throughout the tilt table test.

Your doctor may recommend a tilt table test if you've had repeated, unexplained episodes of fainting. During the test, your blood pressure and heart rate are monitored. You begin by lying flat on a table. Straps are put around your body to hold you in place. Then, the table is tilted to raise your body to a head-up position — simulating a change in position from lying down to standing up. This test allows doctors to evaluate your body's cardiovascular response to the change in position.

What Do I Do on the Day?

The physician may ask the patient to avoid certain medications, to refrain from eating or drinking after midnight the night before the test, or to bring a list of all the medications, vitamins, and supplements that he or she is taking to the test.

How Is It Done?

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) machine that monitors your heart rate.
  • Place a blood pressure cuff 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, if needed.

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).
  • 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 symptoms such as nausea, sweating, light-headedness or irregular heartbeats, tell a member of your health care team.
  • If you don't faint or experience any other symptoms after 45 minutes, a medication 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.

What Are the Risks?

A tilt table test is generally safe, and complications are rare. But, as with any medical procedure, it does carry a risk of complications.

Potential complications include:

  • Prolonged low blood pressure
  • Prolonged pause between heartbeats (asystole)

These complications usually go away when the table that you're lying on during the test is returned to a horizontal position.

What Happens After My 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. Patients can resume normal activities immediately after a tilt table test.

How Do I Get My Results?

A report will be sent to your referring doctor, usually within 24 hours. Your doctor will discuss your results at your next appointment. If you require your report sooner please inform either the reception staff or the technician.