High incidence of ST-T changes in women during tilt-table testing
AffiliationUniv Arizona, Div Cardiol, Sarver Heart Ctr
KeywordsTilt table testing
MetadataShow full item record
CitationPrakash Goutham Suryanarayana, Jagdesh Kandala, Frank I. Marcus, High incidence of ST-T changes in women during tilt-table testing, Journal of Electrocardiology, Volume 50, Issue 6, 2017, Pages 884-888, https://doi.org/10.1016/j.jelectrocard.2017.06.004
JournalJOURNAL OF ELECTROCARDIOLOGY
Rights© 2017 Elsevier Inc. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractIntroduction: We have observed electrocardiographic (ECG) changes primarily in women during tilt table testing. Methods: We reviewed 12 lead ECGs during tilt studies between 2012 and 2016 for changes in ST segments and T waves during tilt table testing. Patients with distinctly abnormal baseline ECGs were excluded. Results: Of the 180 tilt studies, 117 (65%) were in women. There were 32 patients with ECG changes during tilting. Of these, 28 (87.5%) were in women with an average age of 45 years. None had a history of CAD or exertional chest pain. Echocardiograms were available in 21 of the 28 women with tilt induced ECG changes and all were normal. ECG changes during tilt table testing were found in 4/64 (6.25%) of men. The occurrence of ST-T wave changes during tilt testing was significantly higher among women compared to men, with a p value of 0.008. Of the 28 women with ECG changes during tilt, 11 had T wave inversions alone. ST segment depression alone was noted in 7 women. There were 10 women who had both ST segment depression and T wave inversions. Changes occurred immediately upon tilting in 6. In the remaining, they occurred at an average of 4.8 +/- 4 min after tilting. The slight increase in heart rate in patients with ECG changes was similar to that in the patients without new ECG changes. The ECG changes were not related to the presence of syncope. Conclusions: ECG changes during the testing was observed at a relatively high incidence primarily in women. The clinical significance of these repolarization changes during tilt testing is unknown. These ECG changes during tilt testing may correlate with the high incidence of false positive ECGs in women during exercise testing but do not necessarily indicate the presence of ischemic coronary disease. Additional research is needed to explain this phenomenon. (C) 2017 Elsevier Inc. All rights reserved.
Note12 month embargo; published online: 9 June 2017
VersionFinal accepted manuscript
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- Issue date: 2007 Jul
- Prediction of non-occurrence of syncope during a tilt-table test by early heart rate variations.
- Authors: Movahed MR, Hassapoyannes CA
- Issue date: 2001 May
- Prolonged implantable electrocardiographic monitoring indicates a high rate of misdiagnosis of epilepsy--REVISE study.
- Authors: Petkar S, Hamid T, Iddon P, Clifford A, Rice N, Claire R, McKee D, Curtis N, Cooper PN, Fitzpatrick AP
- Issue date: 2012 Nov
- Vasodepressor syncope due to subclinical myocardial ischemia.
- Authors: Ascheim DD, Markowitz SM, Lai H, Engelstein ED, Stein KM, Lerman BB
- Issue date: 1997 Feb
- [Estimation of autonomic nervous system tension in patients with syncope of unknown origin--traps in clinical interpretation results of heart rate variability].
- Authors: Gielerak G, Makowski K, Dłuzniewska E, Roszczyk A, Cholewa M
- Issue date: 2004 May