This article summarizes the major contributions of tilt table tests and implantable loop recorders to the diagnosis of syncope and provides simple recommendations for these tests. Tilt table tests have provided important benefits in the field of neurally mediated syncope. However, they have significant limitations. Implantable loop recorders also are proving very useful. They have identified 2 populations of older patients with syncope who may benefit from permanent pacing. Randomized studies have established the safety and efficacy of their early application in the diagnosis of syncope.
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