What test can be performed on an outpatient basis for patients with recurrent vasovagal syncope?

Tilt table testing is the appropriate option for patients with recurrent vasovagal syncope performed on an outpatient basis. This test is specifically designed to evaluate how the body responds to changes in position and to determine if there is a neurocardiogenic cause for syncope. During the procedure, the patient is strapped to a table that can tilt from a horizontal to a vertical position, while their heart rate and blood pressure are monitored. If the patient experiences syncope or significant changes in heart rate or blood pressure during the test, this can help confirm the diagnosis of vasovagal syncope.

Other tests have their specific roles but are not as directly suited for this context. An electrocardiogram primarily evaluates the electrical activity of the heart and may identify arrhythmias but does not specifically assess the vasovagal response. A Holter monitor is designed to continuously record the heart's activity over 24 hours or longer, which is useful for detecting intermittent arrhythmias but does not replicate the positional changes involved in syncope. Cardiac catheterization, being an invasive procedure to visualize the coronary arteries, is not indicated for assessing vasovagal syncope. Therefore, tilt table testing stands out as the most relevant and effective outpatient test for this condition.