Desmopressin acutely decreases tachycardia and improves symptoms in the postural tachycardia syndrome.

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Samuel T CoffinSatish R Raj

Abstract

Postural tachycardia syndrome (POTS) induces disabling chronic orthostatic intolerance with an excessive increase in heart rate on standing, and many patients with POTS have low blood volume. Increasing blood volume is a promising approach to this problem. To test the hypothesis that desmopressin (DDAVP) will attenuate the tachycardia and improve symptom burden in patients with POTS. In this protocol, patients with POTS (n = 30) underwent acute drug trials with DDAVP 0.2 mg orally and placebo, on separate mornings, in a randomized crossover design. Blood pressure, heart rate, and symptoms were assessed while seated and after standing for up to 10 minutes prior to and hourly for 4 hours following study drug. The standing heart rate was significantly lower following DDAVP than placebo (101.9 ± 14.5 beats/min vs 109.2 ± 17.4 beats/min; P <.001). Standing blood pressure was not affected (P = .28). The symptom burden improved with DDAVP (from a score of 18 ± 18 arbitrary units [AU] to 13 ± 15 AU at 2 hours) compared with placebo (from 18 ± 17 AU to 19 ± 16 AU; P = .010). Oral DDAVP significantly attenuated tachycardia and improved symptoms in POTS. The safety profile of this approach would need to be examined before it can be recomm...Continue Reading

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Citations

Mar 29, 2016·Seminars in Pediatric Neurology·William Qubty, Sita Kedia
Dec 12, 2012·Cardiology Clinics·Victor C Nwazue, Satish R Raj
May 29, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jonathan Weinstock
Feb 6, 2014·Cardiovascular Therapeutics·Elizabeth A GreenSatish R Raj
Mar 13, 2014·Clinical and Experimental Pharmacology & Physiology·Victor C NwazueSatish R Raj
Jul 23, 2015·Current Neurology and Neuroscience Reports·Emily M GarlandSatish R Raj
Mar 12, 2016·JAAPA : Official Journal of the American Academy of Physician Assistants·Daniel PavlikRachel Ditoro
Jul 2, 2014·Frontiers in Physiology·Philip L Mar, Satish R Raj
Sep 24, 2016·Practical Neurology·Pearl K JonesSatish R Raj
Feb 28, 2014·Journal of the American Heart Association·Hongliang LiDavid C Kem
Sep 5, 2013·Journal of the American Heart Association·Elizabeth A GreenSatish R Raj
Jun 12, 2013·Circulation·Satish R Raj
Aug 7, 2018·Cardiology in the Young·Jeffrey R Boris, Thomas Bernadzikowski
Aug 15, 2019·Annual Review of Medicine·Philip L Mar, Satish R Raj
Jul 17, 2020·Journal of the American Heart Association·Emily C SmithLuis E Okamoto
Aug 26, 2020·Journal of Child Neurology·Bashar HasanPhilip R Fischer
Nov 27, 2015·American Journal of Physiology. Heart and Circulatory Physiology·Ashley L WagonerDebra I Diz
Feb 6, 2017·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Alan HakimPeter Rowe
Aug 19, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Ravindra GaneshJohn K DiBaise
May 1, 2021·Journal of the American College of Cardiology·Emily M GarlandSatish R Raj
Apr 19, 2021·The American Journal of Medicine·Marie-Claire SeeleyDennis H Lau
Nov 13, 2021·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Christopher J MathiasAlan Hakim

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