Comparing tilt tests and ECG recordings for diagnosing unexplained fainting in older adults

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study aims to determine whether performing a head-up tilt (HUT) test first in older patients with unexplained syncope leads to quicker and more accurate diagnoses compared to using an implantable loop recorder (ICM) first. A total of 144 patients aged 50 and older, who have experienced at least one fainting spell in the past year without a clear diagnosis, will be randomly assigned to one of the two diagnostic approaches. The primary goal is to establish a documented cause of syncope, with the study designed to reflect real-world clinical practices. This pragmatic trial will follow usual care protocols while assessing the effectiveness of each diagnostic strategy.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* age \>50 years old
* ≥1 syncope26 in the prior 12 months
* diagnosis unclear after history, physical exam, and electrocardiogram
* no apparent risk of death due to the cause of syncope

Exclusion Criteria:

* cannot provide informed consent or attend routine follow up
* have known left ventricular ejection fraction \< 50%,or have
* pacemaker, ICD, or ICM
* Class I indication for permanent pacing or ICD implantation
* hypertrophic cardiomyopathy
* a history of myocardial infarction within 3 months prior to enrolment
* a major chronic co-morbid medical condition that would preclude 12 months of follow-up
* bifascicular block
* epilepsy proven by electroencephalography
* syncope of known cause

Where it's running

• University of Calgary
  Calgary, Alberta, Canada Recruiting

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.