Ömer KÜMET, Remzi SARIKAYA, Mehmet Rasih SONSÖZ, Mehmet AYDOĞAN, Ali ELİTOK, Ahmet Kaya BİLGE
Eastern Journal of Medicine (EJM) - 2026;31(3):427-431
Head-up tilt table test is useful for the evaluation of vasovagal or orthostatic syncope patients. In this study, we aimed to investigate long-term major adverse cardiovascular events in vasovagal syncope patients who showed a positive response to the head up tilt table test. In this single-center descriptive study, all patients admitted to the cardiology tilt test laboratory in a university hospital between 1996-2020 were included. Mortality data of all patients were questioned in 2024. A chi-square test to compare categorical variables, and Mann-Whitney U and Kruskal Wallis tests to compare numerical variables without normal distribution were used. A p-value of <0.05 was accepted for statistical significance. 1016 of a total of 2088 patients had a positive response to the tilt table. The frequencies of outcomes were respectively vasodepressor type (46.6%), type-1 mix type (37.8%), cardio-inhibitor type-2 (10.8%) and cardio-inhibitor type-1 (4.8%). The median age of the patients with cardio-inhibitor type-2 was significantly lower compared to type-1 mix and vasodepressor types (p=0.001). Patients with cardio-inhibitory type-1 response had a relatively higher all cause mortality and mace rates than the tilt negative group and other tilt positive groups. Vasovagal syncope is generally not associated with mortality, but it should be kept in mind that long-term adverse cardiovascular events may occur in patients with cardioinhibitory type 1 features detected by tilt table test.
