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Tilt Table Procedure

What is a tilt table procedure?

A tilt table procedure is a test done to evaluate symptoms of syncope (fainting). If you have syncope, the doctor will carefully evaluate your past medical history and perform a physical exam. If the results of the exam or history do not show a cause for the syncope, and you have no history of heart disease, then further test may be scheduled.

One type of test that may be used to assess syncope is the tilt table procedure. This procedure attempts to cause syncope by creating changes in posture from lying to standing. You will lie flat on a special bed or table with special safety belts and a footrest while connected to electrocardiogram (EKG) and blood pressure monitors. The bed or table is then elevated to an almost standing position (60 to 80 degree vertical angle) to simulate standing up from a lying position. The blood pressure and EKG are measured during the test to evaluate changes during the position changes. If the test causes you to faint, then the cause of the syncope is vasovagal syndrome. The doctor can then prescribe specific treatment for the syncope once the cause is known.

Why might I need the tilt table procedure?

You may need a tilt table test if you have recurring fainting and other causes were ruled out by other tests.

Syncope, or fainting, may be caused by various medical problems. Syncope may occur rarely to frequently, depending on the cause. Some causes of syncope may include:

  • Vasovagal syndrome (also called neurocardiogenic syncope). This is a sudden drop in blood pressure with or without a decrease in heart rate. It’s caused by a problem of the nerves that control the heart and blood vessels.
  • Arrhythmia. This is when a heart rate is too slow, too fast, or is irregular. When this happens, the heart can’t get enough blood flow to the body.
  • Structural heart disease (problems of the heart muscle or valves). Enlargement of the heart muscle or malfunction of one or more of the heart valves may block blood flow within the heart.
  • Heart attack (also called myocardial infarction or MI). This is damage to the heart muscle due to insufficient blood supply.
  • Ventricular dysfunction. This is a weakness or failure of the pumping function of the ventricles (the heart’s major pumping chambers.

There may be other reasons for your doctor to advise a tilt table procedure.

What are the risks of the tilt table procedure?

Possible risks of tilt table testing include:

  • Planned episodes of syncope (fainting)
  • Dizziness or headache
  • Low blood pressure or high blood pressure
  • Nausea
  • Palpitations and/or change in heart rate

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

How do I get ready for the tilt table procedure?

  • Your doctor will explain the procedure to you and offer you the opportunity to ask questions.
  • You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.
  • Tell the technologist if you are allergic to or sensitive to medications or latex.
  • Fasting may be required before the procedure. Your doctor will give you instructions as to how long you should withhold food and/or liquids.
  • If you are pregnant or think you may be, tell your healthcare provider.
  • Tell your doctor of all medications (prescription and over-the-counter) and herbal supplements that you are taking.
  • Tell your doctor if you have a pacemaker.
  • Arrange to have someone drive you home after the procedure, as you will most likely be told not to drive afterwards.
  • Based on your medical condition, your doctor may request other specific preparation.

What happens during the tilt table procedure?

A tilt table procedure may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Generally, a tilt table procedure follows this process:

  1. You will be asked to remove any jewelry or other objects that may interfere with the procedure.
  2. You will be asked to remove clothing from the waist up and will be given a gown to wear.
  3. You will be asked to empty your bladder prior to the procedure.
  4. You will lie down on a special bed or table.
  5. An IV line may be started in your hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed.
  6. EKG electrodes will be placed on your chest and attached to an EKG machine with wire leads. A blood pressure cuff will be placed on your arm and will be attached to an automatic blood pressure monitoring machine.
  7. You will lie flat on the bed initially, then you will be raised to an almost standing angle while on the bed. Straps will be placed across your chest and legs to keep you from falling if you faint during the procedure.
  8. You will remain upright for up to 45 minutes to determine if symptoms such as dizziness, fainting, low heart rate, and/or a low blood pressure occur.
  9. If no symptoms occur, you may be given a medication in your IV to speed up your heart rate. This will be given while you are lying flat again.
  10. After the medication is given (if needed), you will again be tilted upright and monitored for symptoms of dizziness, fainting, low heart rate, and/or a low blood pressure.
  11. Once enough information is obtained, you will be lowered to a flat position and allowed to rest for a while. Your heart rate and blood pressure will be monitored.
  12. When you are stable, the IV line, blood pressure cuff, and EKG electrodes will be removed.
  13. You will be allowed to dress and leave, unless your doctor instructs you differently.

What happens after the tilt table procedure?

You should be able to resume your normal diet and activities, unless your doctor instructs you differently.

Generally, there is no special care following a tilt table procedure.

Tell your doctor if you develop any signs or symptoms you had prior to the test (such as, dizziness or fainting).

Your doctor may give you other instructions after the procedure, depending on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:
  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure

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