title: What is the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome?
abstract: OBJECTIVE
  The aim of this study is to define the optimal duration of tilt testing for the assessment of patients with suspected postural tachycardia syndrome (POTS).
  
  
  RESULTS
  This was a case-control study. Cases were identified retrospectively from a database of patients referred with orthostatic intolerance (OI). All met the diagnostic criteria for POTS. Controls were enrolled prospectively. All subjects underwent tilting to 70 degrees for 40 min if tolerated. Continuous monitoring was provided by a Finometer. Analysis of responses to tilting was performed on 28 cases and 28 controls. The mean age in the case group was 23.6 and in the control group was 26.2. The majority was female in both groups (cases = 4F:3M, controls = 2F:1M). All cases met the criteria for POTS within 7 min of orthostasis. No controls demonstrated a sustained tachycardia. The prevalence of vasovagal syncope (VVS) was 36% in cases vs. 7% in controls (P = 0.02) and 25% in the remaining patients (n = 233) on the OI database (P = 0.259).
  
  
  CONCLUSIONS
  A 10 min tilt will diagnose POTS in the majority of patients. It will not, however, be sufficient to identify the overlap that exists between POTS and VVS. The optimal duration of tilt testing in patients suspected of POTS is 40 min.
authors.affiliation: Clinical Age Assessment Unit, Mid-Western Regional Hospital, Dooradoyle, Limerick, Ireland. sheila.carew@hse.ie
authors.forename: Sheila
authors.initials: S
authors.lastname: Carew
authors.forename: John
authors.initials: J
authors.lastname: Cooke
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Connor
authors.forename: Teresa
authors.initials: T
authors.lastname: Donnelly
authors.forename: Aine
authors.initials: A
authors.lastname: Costelloe
authors.forename: Christine
authors.initials: C
authors.lastname: Sheehy
authors.forename: Declan
authors.initials: D
authors.lastname: Lyons
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D054971:Orthostatic Intolerance / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D054972:Postural Orthostatic Tachycardia Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D018667:Tilt-Table Test / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors