Tilt training program for the prevention of neurocardiogenic syncope in the elderly

Recent reports have shown that tilt training program is a very useful therapy for the prevention of neurocardiogenic syncope in adolescents. However, it is unknown whether or not this therapy is also effective in elderly patients (>65 years old). We studied 8 elderly patients who had recurrent neurocardiogenic syncope which was diagnosed by head-up tilt testing. Mean age was 68 +/-3 years old (5 males and 3 females). In all patients, syncope was induced reproducibly by head-up tilt testing before the training. Syncope was induced at a mean 15 +/- 9 minutes of control tilt in all patients. Tilt training was performed twice a day, for up to 30 min each time every day at home. Patients recorded any daily symptoms and the duration during the training. The head-up tilt test was reevaluated again at after 21st day of the tilt training. The duration of orthostatic training was increased gradually and up to 30 minutes on the 11st day following the training. After the training was completed, no syncope was induced by head-up tilt testing. Patients continued orthostatic training once a day at home. There have been no recurrences of syncope at a mean follow-up period of I I months. We concluded that tilt training program is a very useful and safe therapy for the prevention of tilt-induced neurocardiogenic syncope in elderly patients.