Abstract P204: Sinusoidal Galvanic Stimulation Improves Orthostatic Symptoms In Patients With Postural Tachycardia.

Postural Tachycardia Syndrome (POTS) is characterized by frequent orthostatic symptoms and excessive heart rate increase (>= 30 bpm) on standing in the absence of orthostatic hypotension for more than 6 months. We and others have described a vestibulo-sympathetic reflex that can be engaged by galvanic vestibular stimulation to modulate sympathetic activity (Biaggioni et al., 2000; Kaufmann et al., 2002; Monahan & Ray, 2002; Ray & Carter, 2003, Bent, Macefield et al. 2006). We hypothesize that habituation to sinusoidal galvanic vestibular stimulation will improve orthostatic tolerance. We studied 6 patients with POTS (30.5+/6.0 years, BMI 22.8+/-2.9 kg/m 2 ) in two sessions using sinusoidal galvanic vestibular stimulation (sGVS 0.025 Hz, 2mA) or sham (0.01 mA). Stimulation was applied near mastoid process for 30 min in semi-recumbent position before orthostatic challenge. Patient were upright for a maximum of 15 minutes after each stimulation. Orthostatic change in Vanderbilt Orthostatic Symptom Score (dVOSS), orthostatic heart rate increase (dHR) and blood pressure response were recorded. Non-parametric Wilcoxon test for paired measures with significance level p<0.05 was used. sGVS stimulation reduced overall orthostatic symptom score (dVOSS sham: 32.5+/-9.3 bpm vs dVOSS sGVS: 10.5+/-5.5, p=0.03) and tended to reduce orthostatic HR increase (dHR sham: 65.83+/-11.5 vs dHR sGVS: 46.5+/-10.7 bpm, p=0.06). Blood pressure and tilt time did not change. This pilot study suggests that habituation to sinusoidal vestibular could be used to improve orthostatic symptoms and orthostatic tolerance.

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Cluster Headache: Alterations in Heart Rate, Blood Pressure and Orthostatic Responses During Spontaneous Attacks

Cephalalgia ◽

10.1046/j.1468-2982.1992.1203172.x ◽

1992 ◽

Vol 12 (3) ◽

pp. 172-177 ◽

Cited By ~ 19

Author(s):

Piotr Kruszewski ◽

Carlos Bordini ◽

Alf O Brubakk ◽

Ottar Sjaastad

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Cluster Headache ◽

Rate Increase ◽

Tilt Test ◽

Heart Rate Increase ◽

Headache Patient ◽

Headache Attack ◽

Non Invasive ◽

Cluster Headache Attack

Changes in heart rate and blood pressure (BP) have been monitored beat-to-beat in a cluster headache patient with and without attacks using a non-invasive Doppler servo method. Two attacks were monitored and during one of them a tilt test was carried out. The variability of heart rate and BP was greater during the attack than during the interparoxysmal period. A marked bradycardia occurred during attacks. Systolic BP increased slightly. There was no heart rate increase after tilting during the attack, whereas this was present invariably during tests carried out interparoxysmally. BP changes during “attack tilt” were difficult to evaluate because of large variation. This may be the first observation of a baroreflex arc dysfunction during a cluster headache attack.

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Exam Anxiety Induces Significant Blood Pressure and Heart Rate Increase in College Students

Clinical and Experimental Hypertension ◽

10.3109/10641963.2010.531850 ◽

2011 ◽

Vol 33 (5) ◽

pp. 281-286 ◽

Cited By ~ 19

Author(s):

Zhihong Zhang ◽

Hai Su ◽

Qiang Peng ◽

Qing Yang ◽

Xiaoshu Cheng

Keyword(s):

College Students ◽

Blood Pressure ◽

Heart Rate ◽

Rate Increase ◽

Heart Rate Increase ◽

Exam Anxiety

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Orthostatic Hypotension in a Complex Clinical Setting Use of the Heart Rate Increase/Systolic Blood Pressure Decrease Ratio as a Diagnostic Aid

Journal of Clinical Case Reports and Studies ◽

10.31579/2690-8808/015 ◽

2020 ◽

Vol 1 (3) ◽

pp. 01-03

Author(s):

Jochanan Naschitz

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Orthostatic Hypotension ◽

Rate Increase ◽

Heart Rate Increase ◽

Bedside Test ◽

Therapeutic Decisions ◽

Simultaneous Decrease ◽

Stable Clinical Condition

A simple bedside test to distinguish neurogenic from non-neurogenic causes of orthostatic hypotension (OH) is the ratio of heart rate increase during OH to the simultaneous decrease in systolic blood pressure (SBP), i.e. the ΔHR/ΔSBP ratio. In a patient suffering from persistent OH we monitored the ΔHR/ΔSBP ratio to aid with a targeted therapy. During a six-week period four pairs of postural tests were performed, one in the fasting and the other in the postprandial state. Inconsistency of the ΔHR/ΔSBP ratio under the patient's apparently stable clinical condition was confusing. So, the ΔHR/ΔSBP ratio did not help in taking therapeutic decisions.

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Heart Rate Increase With High-Dose ADHD Drug in Teens

Internal Medicine News ◽

10.1016/s1097-8690(10)70273-0 ◽

2010 ◽

Vol 43 (5) ◽

pp. 34

Author(s):

ROBERT FINN

Keyword(s):

Heart Rate ◽

Rate Increase ◽

High Dose ◽

Heart Rate Increase

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Autonomic dysfunction in post-COVID patients with and witfhout neurological symptoms: a prospective multidomain observational study

Journal of Neurology ◽

10.1007/s00415-021-10735-y ◽

2021 ◽

Author(s):

Alex Buoite Stella ◽

Giovanni Furlanis ◽

Nicolò Arjuna Frezza ◽

Romina Valentinotti ◽

Milos Ajcevic ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Orthostatic Intolerance ◽

Neurological Symptoms ◽

Postural Tachycardia Syndrome ◽

Symptom Scale ◽

Autonomic Symptom ◽

Postural Tachycardia ◽

Ambulatory Services

AbstractThe autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9–31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.

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Effect of muscle mass and intensity of isometric contraction on heart rate

Journal of Applied Physiology ◽

10.1152/jappl.2000.88.2.487 ◽

2000 ◽

Vol 88 (2) ◽

pp. 487-492 ◽

Cited By ~ 17

Author(s):

José M. Gálvez ◽

Juan P. Alonso ◽

Luis A. Sangrador ◽

Gonzalo Navarro

Keyword(s):

Heart Rate ◽

Muscle Mass ◽

Rate Increase ◽

Isometric Exercise ◽

Heart Rate Increase ◽

Maximal Force ◽

Wheel Turn ◽

Obese Subjects ◽

Energetic Expenditure ◽

Handgrip Contractions

The purpose of this study was to determine the effect of muscle mass and the level of force on the contraction-induced rise in heart rate. We conducted an experimental study in a sample of 28 healthy men between 20 and 30 yr of age (power: 95%, α: 5%). Smokers, obese subjects, and those who performed regular physical activity over a certain amount of energetic expenditure were excluded from the study. The participants exerted two types of isometric contractions: handgrip and turning a 40-cm-diameter wheel. Both were sustained to exhaustion at 20 and 50% of maximal force. Twenty-five subjects finished the experiment. Heart rate increased a mean of 15.1 beats/min [95% confidence interval (CI): 5.5–24.6] from 20 to 50% handgrip contractions, and 20.7 beats/min (95% CI: 11.9–29.5) from 20 to 50% wheel-turn contractions. Heart rate also increased a mean of 13.3 beats/min (95% CI: 10.4–16.1) from handgrip to wheel-turn contractions at 20% maximal force, and 18.9 beats/min (95% CI: 9.8–28.0) from handgrip to wheel-turn contractions at 50% maximal force. We conclude that the magnitude of the heart rate increase during isometric exercise is related to the intensity of the contraction and the mass of the contracted muscle.

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Monitoring athletic training status using the maximal rate of heart rate increase

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2015.07.006 ◽

2016 ◽

Vol 19 (7) ◽

pp. 590-595 ◽

Cited By ~ 14

Author(s):

Clint R. Bellenger ◽

Rebecca L. Thomson ◽

Peter R.C. Howe ◽

Laura Karavirta ◽

Jonathan D. Buckley

Keyword(s):

Heart Rate ◽

Athletic Training ◽

Rate Increase ◽

Training Status ◽

Maximal Rate ◽

Heart Rate Increase

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Movement-induced heart rate changes in epileptic and non-epileptic seizures

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000500001 ◽

2009 ◽

Vol 67 (3b) ◽

pp. 789-791 ◽

Cited By ~ 6

Author(s):

Gisele R. de Oliveira ◽

Francisco de A.A. Gondim ◽

Edward R. Hogan ◽

Francisco H. Rola

Keyword(s):

Heart Rate ◽

Motor Activity ◽

Rate Increase ◽

Epileptic Seizures ◽

Baseline Heart Rate ◽

Heart Rate Increase ◽

Event Duration ◽

Rate Analysis ◽

Heart Rate Analysis ◽

Video Eeg

Heart rate changes are common in epileptic and non-epileptic seizures. Previous studies have not adequately assessed the contribution of motor activity on these changes nor have evaluated them during prolonged monitoring. We retrospectively evaluated 143 seizures and auras from 76 patients admitted for video EEG monitoring. The events were classified according to the degree of ictal motor activity (severe, moderate and mild/absent) in: severe epileptic (SE, N=17), severe non-epileptic (SNE, N=6), moderate epileptic (ME, N=28), moderate non-epileptic (MNE, N=11), mild epileptic (mE, N=35), mild non-epileptic (mNE, N=33) and mild aura (aura, N=13). Heart rate increased in the ictal period in severe epileptic, severe non-epileptic, moderate epileptic and mild epileptic events (p<0.05). Heart rate returned to baseline levels during the post ictal phase in severe non-epileptic seizures but not in severe epileptic patients. Aura events had a higher baseline heart rate. A cut-off of 20% heart rate increase may distinguish moderate epileptic and mild epileptic events lasting more than 30 seconds. In epileptic seizures with mild/absent motor activity, the magnitude of heart rate increase is proportional to the event duration. Heart rate analysis in seizures with different degrees of movement during the ictal phase can help to distinguish epileptic from non-epileptic events.

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