Background and Objectives: Neurocardiogenic syncope is a common clinical event, and occurs across all age groups. However, many current medical treatments are insufficient in many cases. Recently, tilt training was proposed as a nonpharmacologic treatment for recurrent neurocardiogenic syncope. But the role of home orthostatic self training is not established to prevent symptoms in patients with neurocardiogenic syncope. Therefore, we have performed a prospective and randomized study to evaluate the effectiveness of repeated self-orthostatic stress training on the prevention of neurocardiogenic syncope.

Subjectives and Methods: We enrolled 42 consecutive patients (24 males and 18 females, mean age 39 yrs, 16~68 yrs) with recurrent neurocardiogenic syncope, who were randomized into two groups ; the tilt training group or the control group. All of them show postitive tilt test at baseline. And patients of treatment group were instructed to perform tilt-training at home by standing against a wall once or twice per day for 4weeks. After then we reevaluated the response of head up tilt test in both groups.

Results: Nine of 42 patients did not take the follow up head-up tilt test, and dropped out. Among the tilt-training group(N=16), 9 patients(56%) had positive response on follow up head-up tilt test. Among the untreated control group(N=17), 9 patients (53%) had positive response on follow up head-up tilt test. In subgroup analyses according to the number of tilt-training sessions or the classified type, we could not find any difference between two groups.

Conclusion: The results of our study indicate that home self-tilt training is ineffective in reducing positive rate of head-up tilt test in neurocardiogenic syncope patients.

Key words
Neurocardiogenic syncope, Head up tilt test, Tilt training