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'The Italian Protocol': a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope.
Europace. 2000 Oct; 2(4):339-42.E

Abstract

Head-up tilt testing potentiated by sublingual nitroglycerin (NTG), advocated by an Italian group, is a simple and safe but still not a standardized, diagnostic tool for the investigation of syncope. In fact, owing to its rapid spread, the original protocol received, often arbitrarily, many subsequent modifications. We now define the best methodology of the test on strictly evidence-based criteria as: stabilization phase of 5 min in the supine position; passive phase of 20 min at a tilt angle of 60 degrees; provocation phase of further 15 min after 400 micrograms NTG sublingual spray. Test interruption is made when the protocol is completed in the absence of symptoms, or there is occurrence of syncope, or occurrence of progressive (> 5 min) orthostatic hypotension. We intend that this protocol, named by us as 'The Italian Protocol', will be accepted as the standard methodology of the tilt test potentiated by sublingual nitrates.

Authors+Show Affiliations

Cardiology Division, Ospedale Santa Maria Annunziata, Firenze, Italy. bartoletti@dada.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

11194602

Citation

Bartoletti, A, et al. "'The Italian Protocol': a Simplified Head-up Tilt Testing Potentiated With Oral Nitroglycerin to Assess Patients With Unexplained Syncope." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 2, no. 4, 2000, pp. 339-42.
Bartoletti A, Alboni P, Ammirati F, et al. 'The Italian Protocol': a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope. Europace. 2000;2(4):339-42.
Bartoletti, A., Alboni, P., Ammirati, F., Brignole, M., Del Rosso, A., Foglia Manzillo, G., Menozzi, C., Raviele, A., & Sutton, R. (2000). 'The Italian Protocol': a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 2(4), 339-42.
Bartoletti A, et al. 'The Italian Protocol': a Simplified Head-up Tilt Testing Potentiated With Oral Nitroglycerin to Assess Patients With Unexplained Syncope. Europace. 2000;2(4):339-42. PubMed PMID: 11194602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 'The Italian Protocol': a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope. AU - Bartoletti,A, AU - Alboni,P, AU - Ammirati,F, AU - Brignole,M, AU - Del Rosso,A, AU - Foglia Manzillo,G, AU - Menozzi,C, AU - Raviele,A, AU - Sutton,R, PY - 2001/2/24/pubmed PY - 2001/2/28/medline PY - 2001/2/24/entrez SP - 339 EP - 42 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 2 IS - 4 N2 - Head-up tilt testing potentiated by sublingual nitroglycerin (NTG), advocated by an Italian group, is a simple and safe but still not a standardized, diagnostic tool for the investigation of syncope. In fact, owing to its rapid spread, the original protocol received, often arbitrarily, many subsequent modifications. We now define the best methodology of the test on strictly evidence-based criteria as: stabilization phase of 5 min in the supine position; passive phase of 20 min at a tilt angle of 60 degrees; provocation phase of further 15 min after 400 micrograms NTG sublingual spray. Test interruption is made when the protocol is completed in the absence of symptoms, or there is occurrence of syncope, or occurrence of progressive (> 5 min) orthostatic hypotension. We intend that this protocol, named by us as 'The Italian Protocol', will be accepted as the standard methodology of the tilt test potentiated by sublingual nitrates. SN - 1099-5129 UR - https://www.unboundmedicine.com/medline/citation/11194602/'The_Italian_Protocol':_a_simplified_head_up_tilt_testing_potentiated_with_oral_nitroglycerin_to_assess_patients_with_unexplained_syncope_ DB - PRIME DP - Unbound Medicine ER -