What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome?

Hdl Handle:
http://hdl.handle.net/10147/206291
Title:
What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome?
Authors:
Carew, Sheila; Cooke, John; O'Connor, Margaret; Donnelly, Teresa; Costelloe, Aine; Sheehy, Christine; Lyons, Declan
Affiliation:
Clinical Age Assessment Unit, Mid-Western Regional Hospital, Dooradoyle,, Limerick, Ireland. sheila.carew@hse.ie
Citation:
Europace. 2009 May;11(5):635-7. Epub 2009 Mar 4.
Journal:
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
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206291
DOI:
10.1093/europace/eup044
PubMed ID:
19264762
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.
Language:
eng
MeSH:
Adult; Case-Control Studies; Female; Humans; Hypotension, Orthostatic/diagnosis/etiology/physiopathology; Male; Orthostatic Intolerance/diagnosis/etiology/physiopathology; Postural Orthostatic Tachycardia Syndrome/*diagnosis/*physiopathology; Prevalence; Prospective Studies; Retrospective Studies; Syncope, Vasovagal/diagnosis/etiology/physiopathology; Tilt-Table Test/adverse effects/*methods; Time Factors
ISSN:
1532-2092 (Electronic); 1099-5129 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorCarew, Sheilaen_GB
dc.contributor.authorCooke, Johnen_GB
dc.contributor.authorO'Connor, Margareten_GB
dc.contributor.authorDonnelly, Teresaen_GB
dc.contributor.authorCostelloe, Aineen_GB
dc.contributor.authorSheehy, Christineen_GB
dc.contributor.authorLyons, Declanen_GB
dc.date.accessioned2012-01-31T16:46:30Z-
dc.date.available2012-01-31T16:46:30Z-
dc.date.issued2012-01-31T16:46:30Z-
dc.identifier.citationEuropace. 2009 May;11(5):635-7. Epub 2009 Mar 4.en_GB
dc.identifier.issn1532-2092 (Electronic)en_GB
dc.identifier.issn1099-5129 (Linking)en_GB
dc.identifier.pmid19264762en_GB
dc.identifier.doi10.1093/europace/eup044en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206291-
dc.description.abstractAIMS: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshCase-Control Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHypotension, Orthostatic/diagnosis/etiology/physiopathologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshOrthostatic Intolerance/diagnosis/etiology/physiopathologyen_GB
dc.subject.meshPostural Orthostatic Tachycardia Syndrome/*diagnosis/*physiopathologyen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshSyncope, Vasovagal/diagnosis/etiology/physiopathologyen_GB
dc.subject.meshTilt-Table Test/adverse effects/*methodsen_GB
dc.subject.meshTime Factorsen_GB
dc.titleWhat is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome?en_GB
dc.contributor.departmentClinical Age Assessment Unit, Mid-Western Regional Hospital, Dooradoyle,, Limerick, Ireland. sheila.carew@hse.ieen_GB
dc.identifier.journalEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal , of the working groups on cardiac pacing, arrhythmias, and cardiac cellular, electrophysiology of the European Society of Cardiologyen_GB
dc.description.provinceMunster-

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