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| Practical experience of “Chinese experts recommendation on the standard procedure of the headup tilt table test” |
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Abstract ObjectiveTo verify the methodological rationality of “Chinese experts recommendation on the standard procedure of the headup tilt table test”, and to find out its shortcomings. MethodsWe selected 600 in and outpatients complaining of syncope for at least once and they applied for the headup tilt table test(HUTT). The subjects were randomly divided into experimental group and control group according to the check sequence, with 300 patients in each group. The operation on the experimental group was strictly instructed by “Chinese experts recommendation on the standard procedure of the headup tilt table test” while the control group adopted the method routinely used in our HUTT laboratory. The time of onset of syncope, positive rate of syncope, the occurrence of positive reactions and the corresponding treatment were observed separately at the basic HUTT stage and sublingual nitroglycerin test(SNHUTT) stage in the two groups.ResultsThere were 393 positive ones in 600 patients, with a positive rate of 65.5%. At basic HUTT stage, the positive rate of experimental group was significantly higher than that of control group[12.00%(36/300) vs. 6%(18/300), χ2=6.593, P=0.010]; the positive reaction time of the two groups was 3-39 min, with an average level of (16.67±9.90) min and a 95% confidence interval of 12.44-20.89 min. At the SNHUTT stage, the positive reaction time of the experimental group and control group was (5.13±4.27) min and (5.28±2.39) min, respectively, with a 95% confidence interval of 4.59-5.89 min. Among the 393 positive patients, there were 90 patients with vascular inhibition accounting for 22.9%, 12 patients with cardiac inhibition accounting for 3.1% and 291 mixedtyped patients accounting for 74.0%. When inclining bed was flatted, in only one patient heart rate or blood pressure did not rise, even after intravenous injection of 1mg atropine was given. We opened the patients vein channel to give normal saline and dopamine(ivgtt) before heart rate and blood pressure gradually restored. ConclusionThe new procedure can significantly increase the positive rate of basic HUTT, but it does not change the incidence and time of positive reaction in SNHUTT. Whether venous access opening before HUTT is needed for all the patients , it remains to be confirmed by further studies.
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2018, Vol. 27 
