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Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
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Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
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Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
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Inspiratory resistance improves postural tachycardia: a randomized study.

Alfredo Gamboa1, Sachin Y Paranjape2, Bonnie K Black2

  • 1From the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.). alfredo.gamboa@vanderbilt.edu.

Circulation. Arrhythmia and Electrophysiology
|March 21, 2015
PubMed
Summary

Using an impedance threshold device (ITD) improved heart rate control and stroke volume in patients with postural tachycardia syndrome during upright posture, suggesting a potential therapeutic benefit.

Keywords:
autonomic nervous systempostural tachycardia syndromestroke volumetachycardia

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Area of Science:

  • Cardiology
  • Physiology
  • Medical Devices

Background:

  • Postural tachycardia syndrome (POTS) is characterized by an excessive heart rate increase upon assuming an upright posture.
  • Orthostatic intolerance is a common and debilitating symptom in POTS patients.
  • Investigating methods to improve hemodynamic stability in POTS is crucial for patient management.

Purpose of the Study:

  • To evaluate the efficacy of an impedance threshold device (ITD) in enhancing orthostatic tolerance in patients diagnosed with POTS.
  • To determine if ITD-induced negative intrathoracic pressure improves cardiac venous return and stroke volume.
  • To assess the impact of ITD on heart rate regulation during orthostatic stress.

Main Methods:

  • A randomized, single-blind, crossover study was conducted involving 26 POTS patients.
  • Participants were tested with both a sham device and an ITD (providing inspiratory resistance).
  • Hemodynamic parameters were measured supine and during 10 minutes of 70° head-up tilt.

Main Results:

  • The ITD significantly reduced heart rate during head-up tilt compared to the sham device (102±4 vs. 109±4 bpm, P=0.003).
  • Stroke volume was significantly increased with the ITD compared to the sham device (35±2 vs. 26±1 mL, P=0.006).
  • No significant differences in baseline hemodynamic parameters were observed between the ITD and sham conditions.

Conclusions:

  • Breathing with an impedance threshold device effectively improves heart rate control in POTS patients in an upright position.
  • The ITD enhances stroke volume, contributing to better hemodynamic stability.
  • These findings support the use of ITD as a non-pharmacological intervention for POTS.