The usefulness of tilt testing with an intravenous beta-blocker in assessing the efficacy of long-term therapy in XXXX with vasovagal syncope.

@entity1 @entity1163 @entity1169
BACKGROUND: Although beta blockers are frequently used for the prevention of recurrences of vaso-vagal @entity1163 , the prediction of the long-term efficacy of this treatment is difficult. AIM: To assess whether the result of tilt testing with an intravenous beta blocker can predict the long-term efficacy of beta blockade. METHODS: The study group consisted of 62 @entity1 (29 females, mean age 32.8+/-12.3 years and 33 males, mean age 35.9+/-18.2 years) with at least two @entity1163 during the six months preceding positive tilt testing. After baseline tilt test, @entity1169 in a dose of 0.1 mg/kg body weight was administered intravenously and the tilt test was repeated. Beta blockade was defined effective if the second tilt test was negative (complete efficacy) or the time to @entity1163 during tilt testing was increased compared with the baseline tilting (partial efficacy). All @entity1 received chronic @entity1169 treatment and were followed for one year or till the recurrence of @entity1163 . RESULTS: Intravenous @entity1169 prevented (n=33) or delayed (n=18) @entity1163 during tilt testing in 51 (82%) @entity1 whereas it was ineffective in the remaining 11 (18%) @entity1 . During 8.6+/-6.7 (range 1-14) months of follow-up, 20 (32%) @entity1 had @entity1163 recurrence; 13 (25%) from the group with effective intravenous @entity1169 versus 7 (64%) @entity1 in whom intravenous @entity1169 did not prevent @entity1163 during tilt testing (p<0.015). Analysis of survival without a recurrence of @entity1163 revealed a significant relationship between the results of tilt testing with intravenous @entity1169 and the efficacy of long-term beta-blocker therapy (p<0.003). There were no significant differences between the predictive value of tilt testing with @entity1169 between @entity1 with complete or partial @entity1169 efficacy (NS) whereas significant differences between each of these two groups and @entity1 with ineffective intravenous @entity1169 were noted (p<0.04 and p<0.002, respectively). CONCLUSIONS: @entity1169 administered intravenously prevents @entity1163 during tilt testing in a significant proportion of @entity1 . Both complete or partial efficacy of intravenous @entity1169 predict long-term efficacy of chronic beta blocker therapy in @entity1 with vaso-vagal @entity1163 .
