Dear Colleagues,
Can anyone tell me if there is a validated method of testing cardiovagal and adrenergic autonomic function testing in patients with atrial fibrillation? With Tilt table testing - is this a validated method in AF?
Lastly, are there any modifications in tilt such as unsupported postural provocation - i.e. sitting, standing, lying (all unsupported)?
Thank you for any guidance.
A validated one specific to vagally mediated atrial fibrillation? No, not that I am aware of. The use of the Tilt Table in general has been validated by others, but I do not see any literature references to it specifically for AFib indications.
The protocol for evaluating neurocardiogenic syncope is not essentially different in patients with atrial fibrillation. It is 70 degree head up tilt for 45 min. As per American College of Cardiology consensus document, in patients with severe left ventricular outflow obstruction, critical mitral stenosis, known proximal coronary artery disease and known critical cerebrovascular stenoses, tilt table testing is relatively contraindicated. Nevertheless, it is always better to obtain go-ahead from a cardiologist, before carrying out HUTT for patients with AF. Also, it is necessary to have all necessary resuscitation facility nearby with the support of a clinician, in case of an eventuality.
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