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Cardiolucent

Procedure

Tilt Table Test

Diagnosing the cause of unexplained fainting

A tilt table test is a controlled study used to diagnose the cause of unexplained fainting (syncope) and orthostatic intolerance. You lie on a motorized table that gradually changes from horizontal to nearly upright while your heart rate, blood pressure, and rhythm are continuously monitored. The test reliably reproduces the abnormal cardiovascular reflex responsible for vasovagal syncope and helps distinguish it from other causes such as orthostatic hypotension or postural orthostatic tachycardia syndrome (POTS). It is performed in a monitored hospital setting.

What's Included

  • Continuous EKG and beat-to-beat blood pressure monitoring
  • Multi-stage table tilt from horizontal to 60-80 degrees upright
  • Provocation phase with sublingual nitroglycerin or isoproterenol if needed
  • Real-time observation by a trained team
  • Reproduction and characterization of symptoms
  • Diagnostic classification of the syncope mechanism
  • Personal review of findings with Dr. Kedan

How It's Performed

The test is performed in a monitored hospital setting at Cedars-Sinai or an affiliated lab. You are secured comfortably on a motorized tilt table, EKG leads and a blood-pressure monitor are placed, and an IV is established. The table is tilted to a near-upright position for 30 to 45 minutes while staff watch for symptom reproduction. If the initial phase is negative, a provocation medication (sublingual nitroglycerin or IV isoproterenol) may be added. Total appointment time is typically 1 to 2 hours.

How to Prepare

  • Nothing to eat or drink for 4 to 6 hours before the test.
  • Take routine medications only if specifically instructed.
  • Hold blood-pressure medications the day of the test if directed.
  • Arrange a driver — symptoms may persist for an hour or two after the test.
  • Wear comfortable, loose clothing.

What to Expect After

If symptoms are induced, you are returned promptly to a flat position and recover within minutes. You may feel briefly weak or lightheaded for an hour or two afterward, which is why a driver is needed. Dr. Kedan reviews the rhythm and blood-pressure tracings personally and discusses the findings and the resulting treatment plan with you in detail at a follow-up.

Indications

  • Recurrent unexplained syncope
  • Distinguishing vasovagal syncope from cardiac syncope
  • Suspected postural orthostatic tachycardia syndrome (POTS)
  • Suspected orthostatic hypotension when standing measurements are inconclusive
  • Atypical lightheadedness or near-fainting episodes
  • Evaluation of high-risk occupations (pilots, drivers) after a syncope event
  • Characterizing syncope mechanism before implanting a loop recorder

Common Questions

Frequently Asked Questions

What is a tilt table test?
It is a controlled study that uses a motorized table to gradually move you from lying flat to a near-upright position while your heart rate, blood pressure, and rhythm are continuously monitored. The goal is to reproduce the cardiovascular reflex responsible for fainting so we can identify the exact mechanism.
Why would I need one?
The most common reason is recurrent unexplained fainting (syncope), particularly when the question is whether it is vasovagal (a benign reflex), orthostatic (blood-pressure drop on standing), or related to POTS (excessive heart-rate rise on standing). The test also helps rule in or rule out cardiac causes when paired with other studies.
Where is it performed?
In a monitored hospital setting at Cedars-Sinai or an affiliated lab. The test requires continuous monitoring and the ability to administer medications safely.
How long does it take?
Plan on 1 to 2 hours from arrival to discharge. The tilted portion is typically 30 to 45 minutes for the first phase and another 15 to 20 minutes if a provocation phase is needed.
Is it painful?
No. The IV placement is the only discomfort. The test itself is meant to reproduce your symptoms, however — meaning you may experience lightheadedness, nausea, or even briefly faint. The team returns you to flat the moment symptoms appear, and recovery is rapid.
How do I prepare?
Fast for 4 to 6 hours, take routine medications only as instructed, hold blood-pressure medications if directed, arrange a driver, and wear comfortable clothing.
Are there any risks?
The test is safe and performed continuously under medical supervision. The induced symptoms (lightheadedness, fainting) are the point of the test — they resolve quickly once you are returned to flat. Rare side effects relate to the provocation medications when those are used.
What does a positive test mean?
A positive test confirms a specific syncope mechanism — most often a vasovagal pattern — that explains your symptoms and points to targeted treatment. A negative test reduces the likelihood of certain causes and helps guide the next step in the workup.
When will I get my results?
Preliminary findings are often discussed immediately after the test. The formal report is available within 24 to 48 hours, and Dr. Kedan reviews it with you at a dedicated follow-up.
How do I schedule one?
A tilt table test is ordered after a clinical evaluation that confirms it is the right next step. Call Cardiolucent at (310) 304-5555 to begin the workup.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.