[Tilt-table-testing in childhood: non-invasive, continuous hemodynamic monitoring].

BACKGROUND: Approximately 15% of children experience a syncope before the age of 18 years. Tilt table testing represents the diagnostic gold standard whenever a neurocardiogenic spell is suspected. Two methods of continuous, non-invasive hemodynamic monitoring during the tilt table test are presented and their usefulness for clinical routine is discussed.

PATIENTS: 4 patients with suspected neurocardiogenic syncope.

METHODS: Tilt table testing according to standard protocol; non-invasive, continuous blood-pressure measurement by finger cuffs; impedance cardiography for the assessment of cardiac output.

RESULTS: In 3 patients a syncope occured during the tilt table test. In pt. 4 characteristic symptoms led to diagnosis prior to syncope. Every patient represents a definite type of neurocardiogenic syncope (cardioinhibitory with asystolia, vasodepressory, mixed as well as postural tachycardia syndrome).

CONCLUSIONS: Both monitoringmethods allow a differentiated analysis of the cardiovascular interactions during the tilt table test. Thus, specific regulatory patterns may be diagnosed and specific treatment strategies may be offered.