Head-up tilt table evaluation in a trained athlete with recurrent vaso-vagal syncope.

A 27-year-old trained athlete with recurrent syncope of suspected vaso-vagal origin was evaluated. A 60 degrees head-up tilt table test reproducibly triggered the patient's spontaneous symptoms and allowed the investigation of different modalities of therapy (medical and pacing) in preventing syncopal episodes. The head-up tilt table test may be a useful tool in the evaluation of syncope of vaso-vagal origin, helping to determine the initial precipitating vagal event and the effect of therapy.