Tilt training (TTr) may be an effective therapeutic option for refractory reflex syncope (rS), according to research presented at the European Heart Rhythm Association 2019 congress earlier this month.
The study included 102 adults with orthostatic-induced rS, refractory to conventional measures, who took part in a TTr programme. As part of this programme, participants lay on a table that moved up to 60° for six sessions and 70° for three sessions - each time staying raised for 20-30 minutes, during which they underwent electrocardiogram (ECG) and blood pressure (BP) monitoring. The in-hospital programme was combined with home orthostatic self-training.
After an average follow-up of 5.5 years, most of the patients did not present recurrent episodes of syncope (n=89; 86.3%) or pre-syncope (n=82; 80%), while in the remaining patients (14%), there was a significant decrease in the number of syncopes and pre-syncope. The programme was also associated with significantly less worry, fear and frustration related to fainting.
"These results show that tilt training is a safe and effective treatment option for selected patients with recurrent syncopal episodes," said study author Dr Sergio Laranjo, of the Hospital Santa Marta, Lisbon, Portugal.