Inspiratory resistance improves postural tachycardia: a randomized study

Circulation. Arrhythmia and Electrophysiology
Alfredo GamboaSatish R Raj

Abstract

The objective of this study was to determine the effect of inspiratory resistance through an impedance threshold device (ITD) on orthostatic tolerance in patients with postural tachycardia syndrome. We hypothesized that the ITD would result in a greater negative intrathoracic pressure to enhance cardiac venous return, improve stroke volume, and reduce heart rate in these patients. We compared the effect of a sham device (sham, no resistance) versus an ITD (increased inspiratory resistance) in 26 patients with postural tachycardia syndrome in a randomized, single-blind, crossover study. Hemodynamic assessments were performed at baseline while supine and during head-up tilt to 70° for 10 minutes. We did not find differences in baseline hemodynamic parameters between the ITD and the sham devices. After 10 minutes of head-up tilt, the heart rate was lower with the ITD versus sham device (102±4 versus 109±4 beat/min, respectively; P=0.003). The ITD also improved stroke volume compared with the sham device (35±2 versus 26±1 mL; P=0.006). These findings suggest that increasing negative intrathoracic pressure with ITD breathing improves heart rate control in patients with postural tachycardia syndrome during upright posture. clinicaltr...Continue Reading

Associated Clinical Trials

References

Mar 1, 1986·Annals of Internal Medicine·F M FouadR C Tarazi
Aug 1, 1997·The American Journal of Medicine·G JacobI Biaggioni
Jan 6, 1999·Controlled Clinical Trials·W D Dupont, W D Plummer
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Jul 14, 2007·Journal of Applied Physiology·Shizue MasukiMichael J Joyner
Jun 29, 2010·Journal of the American College of Cardiology·Qi FuBenjamin D Levine
Jul 17, 2010·The Journal of Emergency Medicine·Stephen W SmithJoseph Clinton
May 18, 2013·Journal of Applied Physiology·Samuel J E LucasPhilip N Ainslie
Jun 12, 2013·Circulation·Satish R Raj

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Citations

Jun 22, 2019·Journal of Applied Physiology·Victor A Convertino
Jan 23, 2021·Journal of the American College of Cardiology·Kate M BourneSatish R Raj

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