How is a Tilt-Table Test Performed?

Doctors use Tilt-Table test to trigger hypotension symptoms when standing upright while watching the patients. They measure your blood pressure and heart rate during the test to find out what’s causing your symptoms. The test is normal if your average blood pressure stays stable as the table tilts upward and your heart rate increases by a normal amount.

A nurse or technician with special training performs the tilt-table test in a hospital or clinic EP (electrophysiology) lab. The test has two parts.

Part One
The first part of the test shows how your body responds when you change positions.

  • You lie on your back on a table. Straps at your waist and knees help you stay in position. An IV (intravenous line) is put in your arm. Small discs with wires are attached to your chest and are connected to an ECG (electrocardiograph) machine to track your heartbeat. A cuff on your arm measures your blood pressure.
  • The nurse tilts the table so your head is slightly higher (30 degrees) than the rest of your body. The nurse checks your blood pressure and your heart rate.
  • After about 5 minutes, the nurse tilts the table more. Now you are lying at a 60-degree angle or higher. The nurse continues to check your blood pressure and your heart rate for up to 45 minutes. The nurse will ask you to stay still and quiet during this time, but you should tell the nurse if you feel uncomfortable.
  • If your blood pressure drops during this time, the nurse will lower the table and stop the test. You won’t need to take the second part of the test. If your blood pressure does not drop after the time is up, the nurse will lower the table and start the second part of the test.

“I guess my blood pressure dropped very quickly, and the nurses told me they could see my ECG change. I didn’t realize it was the end of the test but they said they had gotten all of the information they needed.”  Mary, age 78

Part Two
The second part of the test shows how your body responds to a medicine (isoproterenol) that causes your heart to beat faster and stronger. This medicine is like the hormone adrenaline that your body releases when you are under stress. This medicine may make you feel as if you are exercising. It may make you more sensitive to the tilt-table test if your blood pressure didn’t change during the first part of the test.

  • The nurse gives you medicine through your IV tube.
  • Next, the nurse tilts the table upwards to a 60-degree angle.
  • You may feel your heartbeat increase because of the medicine.
  • If your blood pressure drops, the nurse will lower the table to the flat position, stop the medicine, and the test will end.
  • If your blood pressure does not drop after about 15 minutes, the nurse will lower the table and the test will be over.

The tilt-table test can last about 90 minutes if you do both parts of it. If you only do the first part, you may be done in 30 to 40 minutes.

Risks

There are few risks. People rarely faint during tilt-table tests. And even if they do, it’s safer than fainting on your own in an uncontrolled situation. If a person does faint, usually they feel well again within a minute or so after the table returns to a flat position.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.