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

Syncope Trial to Understand Tilt Testing or ECG Recording. Tenth Prevention of Syncope

NA · University of Calgary · NCT05776810

This study is testing whether doing a tilt test first helps doctors diagnose the cause of fainting better and faster in older adults compared to using a heart monitor first.

Quick facts

PhaseNA
Study typeInterventional
Enrollment144 (estimated)
Ages50 Years to 110 Years
SexAll
SponsorUniversity of Calgary (other)
Locations1 site (Calgary, Alberta)
Trial IDNCT05776810 on ClinicalTrials.gov

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.

Who should consider this trial

Good fit: Ideal candidates are individuals aged 50 and older who have experienced at least one fainting episode in the past year with no clear diagnosis.

Not a fit: Patients with known causes of syncope or significant heart conditions may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to faster and more accurate diagnoses for older patients experiencing unexplained syncope.

How similar studies have performed: While similar diagnostic approaches have been explored, this specific comparison of HUT versus ICM in older adults is novel.

Eligibility criteria

Show full inclusion / exclusion criteria
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 this trial is running

Calgary, Alberta

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Syncope

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.