BACKGROUND AND PURPOSE: @entity135 ( @entity135 ) testing is a widely used diagnostic tool in @entity1 with suspected @entity907 ( @entity907 ). However, no gold standard exists for this examination and the various protocols used have a limited sensitivity and specificity. Our aim was to determine the sensitivity of a sequential @entity135 testing protocol including venepuncture (VP) and sublingual @entity1242 application. METHODS: This was a retrospective analysis of the diagnostic gain of a sequential @entity135 testing protocol including VP applied 10 min after the start of @entity135 testing and sublingual application of @entity1242 20 min after the start of the test protocol in 106 @entity1 with a final diagnosis of @entity907 . The sensitivity of the test protocol was compared between @entity1 with positive and negative history for VP induced @entity907 . RESULTS: Overall, pre- @entity1163 or @entity1163 occurred in 68 @entity1 (64.2%). Only 17% of all @entity1 fainted spontaneously within 10 min of passive @entity135 . Another 39.6% fainted within 20 min. Application of @entity1242 after 20 min of @entity135 evoked @entity1163 in another 7.5% until the end of 45 min of @entity135 . The sensitivity of the test protocol for evoking (pre-) @entity1163 was 94.4% in @entity1 with a positive history for VP associated @entity907 and 58% in @entity1 with a negative history (P < 0.01**); 85.7% of @entity1 with a positive history and 42.9% of @entity1 with a negative history fainted within 20 min of @entity135 testing (P < 0.01**). CONCLUSIONS: Implementation of VP in sequential @entity135 testing protocols allows the sensitivity of @entity135 testing to be increased, especially in @entity1 with a positive history for VP associated @entity907 .

Venepuncture during head-up tilt testing in @entity1 with suspected XXXX for the test protocol.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity135 :: ('MESH:D006258', 'Disease') :: ['HUT', 'Head-up tilt'] @entity907 :: ('MESH:D019462', 'Disease') :: ['vasovagal syncope', 'VVS'] @entity1242 :: ('MESH:D005996', 'Chemical') :: ['nitroglycerin'] @entity1163 :: ('MESH:D013575', 'Disease') :: ['syncope']
@entity907 :: (MESH:D019462,Disease) :: ['vasovagal syncope     implications']
