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What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome?
Europace. 2009 May; 11(5):635-7.E

Abstract

AIMS

The aim of this study is to define the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome (POTS).

METHODS AND RESULTS

This was a case-control study. Cases were identified retrospectively from a database of patients referred with orthostatic intolerance (OI). All met the diagnostic criteria for POTS. Controls were enrolled prospectively. All subjects underwent tilting to 70 degrees for 40 min if tolerated. Continuous monitoring was provided by a Finometer. Analysis of responses to tilting was performed on 28 cases and 28 controls. The mean age in the case group was 23.6 and in the control group was 26.2. The majority was female in both groups (cases = 4F:3M, controls = 2F:1M). All cases met the criteria for POTS within 7 min of orthostasis. No controls demonstrated a sustained tachycardia. The prevalence of vasovagal syncope (VVS) was 36% in cases vs. 7% in controls (P = 0.02) and 25% in the remaining patients (n = 233) on the OI database (P = 0.259).

CONCLUSION

A 10 min tilt will diagnose POTS in the majority of patients. It will not, however, be sufficient to identify the overlap that exists between POTS and VVS. The optimal duration of tilt testing in patients suspected of POTS is 40 min.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Carew S
Clinical Age Assessment Unit, Mid-Western Regional Hospital, Dooradoyle, Limerick, Ireland. sheila.carew@hse.ie
Cooke J
No affiliation info available
O'Connor M
No affiliation info available
Donnelly T
No affiliation info available
Costelloe A
No affiliation info available
Sheehy C
No affiliation info available
Lyons D
No affiliation info available

MeSH

AdultCase-Control StudiesFemaleHumansHypotension, OrthostaticMaleOrthostatic IntolerancePostural Orthostatic Tachycardia SyndromePrevalenceProspective StudiesRetrospective StudiesSyncope, VasovagalTilt-Table TestTime Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19264762

Citation

Carew, Sheila, et al. "What Is the Optimal Duration of Tilt Testing for the Assessment of Patients With Suspected Postural Tachycardia Syndrome?" Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 11, no. 5, 2009, pp. 635-7.
Carew S, Cooke J, O'Connor M, et al. What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome? Europace. 2009;11(5):635-7.
Carew, S., Cooke, J., O'Connor, M., Donnelly, T., Costelloe, A., Sheehy, C., & Lyons, D. (2009). What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome? Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 11(5), 635-7. https://doi.org/10.1093/europace/eup044
Carew S, et al. What Is the Optimal Duration of Tilt Testing for the Assessment of Patients With Suspected Postural Tachycardia Syndrome. Europace. 2009;11(5):635-7. PubMed PMID: 19264762.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome? AU - Carew,Sheila, AU - Cooke,John, AU - O'Connor,Margaret, AU - Donnelly,Teresa, AU - Costelloe,Aine, AU - Sheehy,Christine, AU - Lyons,Declan, Y1 - 2009/03/04/ PY - 2009/3/7/entrez PY - 2009/3/7/pubmed PY - 2009/6/27/medline SP - 635 EP - 7 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 11 IS - 5 N2 - AIMS: The aim of this study is to define the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome (POTS). METHODS AND RESULTS: This was a case-control study. Cases were identified retrospectively from a database of patients referred with orthostatic intolerance (OI). All met the diagnostic criteria for POTS. Controls were enrolled prospectively. All subjects underwent tilting to 70 degrees for 40 min if tolerated. Continuous monitoring was provided by a Finometer. Analysis of responses to tilting was performed on 28 cases and 28 controls. The mean age in the case group was 23.6 and in the control group was 26.2. The majority was female in both groups (cases = 4F:3M, controls = 2F:1M). All cases met the criteria for POTS within 7 min of orthostasis. No controls demonstrated a sustained tachycardia. The prevalence of vasovagal syncope (VVS) was 36% in cases vs. 7% in controls (P = 0.02) and 25% in the remaining patients (n = 233) on the OI database (P = 0.259). CONCLUSION: A 10 min tilt will diagnose POTS in the majority of patients. It will not, however, be sufficient to identify the overlap that exists between POTS and VVS. The optimal duration of tilt testing in patients suspected of POTS is 40 min. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/19264762/What_is_the_optimal_duration_of_tilt_testing_for_the_assessment_of_patients_with_suspected_postural_tachycardia_syndrome DB - PRIME DP - Unbound Medicine ER -