Personalized Simulated HUT as an At-home Prediction Model for Heart Rate Changes in Syncope Patients and At-home, Orthostatic Self-training Efficacy

Head-up tilt (HUT) testing supports the diagnosis of syncope by detecting abnormalities in heart rate and blood pressure changes. Home-based self-training can be of benefit to neurocardiogenic patients if during clinical HUT, heart rate decreases in the early stage of being in an upright position. However, HUT testing is not always possible in the hospital as it is inconvenient and sometimes even risky for patients with cardiac abnormalities as it may trigger a loss of consciousness and arrhythmia. To address this, the current paper introduces a personalized HUT simulation to determine the efficacy of at-home training. To develop the model, Holter ECG recordings were obtained from 28 syncope patients and the simulated output was compared to clinical findings. The model aims to predict heart rate changes associated with the simulated HUT that can indicate efficacy of an at-home program. Heart rate represents a variable of velocity in the model measured in liters per second against gravity. The results show that a decrease in heart rate in early simulated HUT as determined by the model shows a greater than 84% efficiency for syncope patients to benefit from at-home training and allows physicians to recommend home training during an online or telemedicine consultation. Keywords— head-up tilt test, syncope, blood flow, heart rate prediction Clinical Relevance— The cardiovascular model predicts the patient-specific efficacy of at home tilt-training for patients diagnosed with syncope.