• Shishir Mathur, Danette Guertin, Craig I Coleman, Paul D Thompson, and Jeffrey Kluger.
• Dept of Cardiology, Harfford Hospital, University of Connecticut, Hartford, USA. drshishirmathur@gmail.com
• Conn Med. 2013 Aug 1; 77 (7): 421-5.

AimsPhysical exercise is known to alter the physiological response to orthostatic stress. This study compared reported physical activity levels in patients with unexplained syncope who did or did not demonstrate positive responses to carotid sinus massage and head-up tilt-table testing.MethodsWe reviewed the records of 1,336 patients with unexplained syncope who underwent carotid sinus massage and head-up tilt-table testing. Patients with positive responses (cases) were compared with patients with negative responses (controls). Multivariable regression analysis was used to identify independent predictors of positive responses to carotid sinus massage and head-up tilt-table testing.ResultsSeventy patients had a positive response to carotid sinus massage and 564 patients had a positive response to head-up tilt-table testing. Physical activity was an independent positive predictor of a positive response to both carotid sinus massage {adjusted odds ratio (AOR) 1.86, 95% CI (1.14-3.05); p = 0.01} and head-up tilt-table testing {AOR 1.31, 95% CI (1.04-1.65); P = 0.02} even after adjustment for multiple other factors including age, gender, and other medical conditions.ConclusionPhysical activity is associated with greater likelihood of positive responses during carotid sinus massage and head-up tilt-table testing.

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