A prospective, 1-year follow-up study of postural tachycardia syndrome

Kurt Kimpinski, Juan J. Figueroa, Wolfgang Singer, David M. Sletten, Valeria Iodice, Paola Sandroni, Philip R. Fischer, Tonette L. Opfer-Gehrking, Jade A. Gehrking, Phillip A. Low

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Abstract

Objective: To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function. Methods: Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of≥30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms. Results: Patients were predominantly young females (n=49, 84%), with 20 patients (34%) reporting an antecedent viral infection before onset of symptoms. More than one-third (37%) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8=15.1 beats/min) compared with baseline (37.8=14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95%) at baseline and 48 patients (92%) at 1 year. Conclusion: To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS.

Original languageEnglish (US)
Pages (from-to)746-752
Number of pages7
JournalMayo Clinic proceedings
Volume87
Issue number8
DOIs
StatePublished - Aug 2012

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Kimpinski, K., Figueroa, J. J., Singer, W., Sletten, D. M., Iodice, V., Sandroni, P., Fischer, P. R., Opfer-Gehrking, T. L., Gehrking, J. A., & Low, P. A. (2012). A prospective, 1-year follow-up study of postural tachycardia syndrome. Mayo Clinic proceedings, 87(8), 746-752. https://doi.org/10.1016/j.mayocp.2012.02.020