Abstract Details

Title The Safety and Practicality of Tilt Table Testing Without Physician Presence

Topic Practice, Policy, and Ethics

Presentation(s) Practice, Policy, and Ethics Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 002

Objective To determine the feasibility of tilt table testing without the presence of a physician to increase the availability of testing.

Background The tilt table test is a high yield diagnostic test in determining the cause of syncope. While widely used, there remains institutional variation in testing implementation. This study creates a protocol to transition from physician-led to technician-led tilt table testing while maintaining the safety of current testing. This study also suggests that safety and efficacy is maintained through this transition which will help increase the supply of testing.

Design/Methods This observational study involved recruitment of 105 participants who underwent standard tilt testing with Valsalva testing in the presence of a highly-trained technician over a physician at a large academic hospital. Subjects were properly consented with exclusion criteria and protocol mirroring those of our institution's standard tilt table protocol. All data including adverse events were collected by the technician. Study results were interpreted by a trained physician and characterized as normal or abnormal: orthostatic hypotension (OH), postural orthostatic tachycardia syndrome (POTS), or cardiovagal abnormality (CVA).

Results A total of 105 data points were collected, three were excluded due to multiple diagnosis. A total of 102 data points were analyzed with an average age of 35.8 years, 78% of the group being female. Among the 102 patients, 45% had an abnormal tilt result – 35% were diagnosed with POTS. There were no adverse effects recorded during study procedure. Access to prior year hospital data also demonstrated no adverse effects with a physician present.

Conclusions Tilt table testing without physician presence is feasible and suggests that testing may be performed with a highly trained technician. This study will allow the push towards increasing the supply of tilt testing. A future study may also involve exploring the relationship between the white coat effect and tilt test outcomes.

Authors/Disclosures
Greg Owendoff PRESENTER	Greg Owendoff has nothing to disclose.
	No disclosure on file
Robert G. Wilson, DO (cleveland clinic)	Dr. Wilson has nothing to disclose.

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