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VV can be caused by myriad triggers - straining for bowel movement has been one of my triggers on two occasions. This may be wild but a nurse via phone told me to sit on toilet with my feet propped up on a bathroom stool (no pun intended). I am one of the few that hasn't ever had a tilt test and I don't want it because I know I have VV so what's the point. I have had various cardiac tests but my causes I think are more metabolic that cadiac related though I am still waiting for results from an EEG next week. My epdisodes came years apart for many years but recently has come in waves.