Abstract: AIM To evaluate the effect of tilt training on patients with vasovagal syncope (VVS). METHODSIn this study we enrolled eight patients with clinical diagnosis of VVS and two consecutive positive results in tilt tests. The 75° head-up tilt training was repeated one session per day for 5 days and follow-up tilt testing was performed after training. ECG, arterial blood pressure and cardiac function were recorded during subsequent tilt testing. RESULTSIn all patients, the follow-up tilt test after training resulted in being negative. Compared with those before training, the heart rate variability low frequency power and the ratio of low frequency power to high frequency power increased significantly (P<0.05), whereas the high frequency power decreased after tilt training in the supine position (P<0.05). In addition, blood pressure and stroke volume increased (P<0.05), whereas heart rate decreased significantly (P<0.01) after tilt training at the end-time of tilt testing. CONCLUSIONDaily repeated tilt training for 5 days restores orthostatic tolerance in patients with VVS, at least in part by improving autonomic cardiovascular control and increasing the amount of vasoconstriction during sustained orthostatic stress.