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While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous events. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to the performance of (1) additional provocation tests, such as the active standing test, carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO<jats:sub>2<\/jats:sub> or neuro-endocrine tests; and (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.<\/jats:p>","DOI":"10.1007\/s10286-020-00738-6","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T10:58:40Z","timestamp":1616151520000},"page":"369-384","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":88,"title":["Recommendations for tilt table testing and other provocative cardiovascular autonomic tests in conditions that may cause transient loss of consciousness"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1435-8970","authenticated-orcid":false,"given":"Roland D.","family":"Thijs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1845-5607","authenticated-orcid":false,"given":"Michele","family":"Brignole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7394-7161","authenticated-orcid":false,"given":"Cristian","family":"Falup-Pecurariu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2854-4179","authenticated-orcid":false,"given":"Alessandra","family":"Fanciulli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3976-6022","authenticated-orcid":false,"given":"Roy","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0597-603X","authenticated-orcid":false,"given":"Pietro","family":"Guaraldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4518-0706","authenticated-orcid":false,"given":"Jens","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3360-1748","authenticated-orcid":false,"given":"Mario","family":"Habek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6802-1751","authenticated-orcid":false,"given":"Max","family":"Hilz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-1553","authenticated-orcid":false,"given":"Anne Pavy-Le","family":"Traon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Stankovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-7784","authenticated-orcid":false,"given":"Walter","family":"Struhal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Wenning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6953-7573","authenticated-orcid":false,"given":"J. 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Dr Fanciulli reports royalties from Springer Nature Publishing Group and Thieme Verlag, speaker fees from the Austrian Autonomic Society, Austrian Neurology Society, Austrian Parkinson Society, Ordensklinikum Linz, International Parkinson Disease and Movement Disorders Society and Theravance Biopharma, research grants from the Stichting ParkinsonFond, MSA Coalition and the \u00d6sterreichischer Austausch Dienst, outside the submitted work. Prof Sutton serves as consultant to Medtronic Inc., is a member of the Speakers Bureau of SJM Abbott Laboratories, and shareholder in Edwards Lifesciences and Boston Scientific Corp., outside of the submitted work. Prof Pavy-Le Traon reports a research grant from the French Ministry of Health outside the submitted work. Prof Jordan served as advisor for Novo-Nordisk, Bayer, received research support from Boston Scientific and Boehringer Ingelheim and is cofounder of Eternygen GmbH, outside the submitted work. Prof. Habek participated as clinical investigator, speaker and\/or advisor for Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva\/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals, outside the submitted work. Prof Struhal reports consultancy for Boehringer, Eli Lilly, royalties from Manz-Rechtsverlag, Springer, Oxford University Press, speaker fees from Boehringer, Merz, Medconvent, Donau-Universit\u00e4t Krems, Austrian Society of Neurology, Manz-Rechtsverlag. Prof. Hilz received consulting honoraria from Alnylam and Sanofi-Genzyme, lecturing honoraria and travel support from Bayer HealthCare, Amicus, Sanofi-Genzyme, and research funding from Novartis Pharma and Bayer Health Care.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}