How is a tilt table test performed?

Before the tilt table test starts, small sticky electrode patches will be applied to your chest, legs and arms, with wires connecting to an electrocardiogram recorder that will monitor your heart rate and rhythm. You will also have a blood pressure cuff wrapped around your arm. An intravenous line will be placed in your arm or the back of your hand. This may be used for taking blood samples or for giving you a medication during the test. Large patches that lead to an external pacemaker may also be applied to your chest, just in case your heart rate drops during the tilt table test and does not return to normal quickly enough.

You will then lie on the flat table and be held in place with straps around your chest and legs. The table also has a foot rest for safety. After you have been lying quietly for several minutes, a resting blood pressure and heart rate are recorded; then the table is tilted from flat to nearly upright. In some cases you may be partially tilted for several minutes before being positioned upright.

How long you stay in the upright position depends on whether you develop dizziness or fainting, how soon these symptoms appear and the particular testing procedures your doctor uses. You may stay upright for as long as 45 minutes. It is important to stay very still during the test and avoid moving or flexing the muscles in your legs.

If no symptoms appear after that time, the table will be returned to its original flat position and you may be given a medication (isoproterenol) that is similar to adrenaline. It will magnify your body’s response to the change in position. The table is then tilted back up to a nearly upright position for another 15 or 20 minutes. If you become dizzy or faint, the medication will be stopped and you will be returned to a flat position. Most people regain consciousness with a few seconds.

After the test, you will be monitored for short time to make sure your heart rate and blood pressure have returned to normal, and then you will most likely be discharged to go home.