Vagus Nerve Stimulation in Treatment of Postural Orthostatic Tachycardia Syndrome
- Conditions
- Postural Orthostatic Tachycardia Syndrome
- Interventions
- Device: Parasym (TM) Transcutaneous Electrical Nerve Stimulation (TENS) Device
- Registration Number
- NCT03930914
- Lead Sponsor
- University of Oklahoma
- Brief Summary
Postural orthostatic tachycardia (POTS) is characterized by abnormalities in the autonomic nervous system in the body. The autonomic nervous system controls and regulates body functions such as heart rate, breathing, digestion, and more.
The investigator has shown that patients with POTS have higher cardiovascular and adrenergic activating autoantibodies (AAb), which likely changes the normal make-up of POTS. There are autoantibodies that have been suggested by a few reports of their presence in POTS, but their role different aspects of POTS is unknown. The study will look at the body's responses in patients with POTS. The crossover study design is to have half of the patients will start with sham followed by active stimulation and half will start by active followed by sham stimulation. It is anticipated that results will provide a potential therapeutic approach based on the understanding of POTS.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 5
-Female or male participants age 18-80
Group 1 (20 participants):
- A physician-based diagnosis of POTS
- Participants that have a postural pulse rise of >35 for adolescents and >30 for adults with a Blood Pressure (BP) that does not drop >10/5 mmHg will be qualified. These participants may be on salt and fluid loading.
Group 2 (10 participants):
- Previously diagnosed with POTS
- Patients is on Intravenous immunoglobulin (IVIG) infusion but who have an incomplete symptomatic response
- Age < 18 years
- Sick sinus syndrome, 2nd or 3rd degree Atrioventricular (AV) block, bifascicular block or prolonged 1st degree AV block (PR>300ms).
- Currently pregnant women or women planning on becoming pregnant ≤ 6 months
- History of hypotension due to autonomic dysfunction
- Have a secondary causes of tachycardia (acute anemia or blood loss, drugs, significant cardiomyopathy, diabetes mellitus)
- Patients with active implants (such as a cardiac pacemaker, or a cochlear implant).
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Active Treatment to Sham Parasym (TM) Transcutaneous Electrical Nerve Stimulation (TENS) Device Subjects randomized to the sequence Active Treatment/Sham Treatment arm will be instructed to first use the Parasym (TM) TENS device as active treatment for the first phase of the study. Next, they will be instructed to use the Parasym (TM) TENS device as sham treatment for the second phase of the study. Sham to Active Treatment Parasym (TM) Transcutaneous Electrical Nerve Stimulation (TENS) Device Subjects randomized to the sequence Sham Treatment/Active Treatment arm will be instructed to use the Parasym (TM) TENS device as sham treatment for the first phase of the study. Next, they will be instructed to use the Parasym (TM) TENS device as active treatment for the second phase of the study.
- Primary Outcome Measures
Name Time Method Long term effects on M2 muscarinic autoantibody levels 2 and 4 months The average change in M2 muscarinic autoantibody levels measured from blood specimens obtained after two and four months of daily vagal nerve stimulation.
Long term effects on beta 1-adrenergic autoantibody levels 2 and 4 months The average change in beta 1-adrenergic autoantibody levels measured from blood specimens obtained after two and four months of daily vagal nerve stimulation.
Long term effects on alpha 1-adrenergic autoantibody levels 2 and 4 months The average change in alpha 1-adrenergic autoantibody levels measured from blood specimens obtained after two and four months of daily vagal nerve stimulation.
Average change in heart rate variability 2 and 4 months We will measure the average change in heart rate variability based on 5 minute ECG after two and four months of daily vagal nerve stimulation
Average change in orthostatic heart rate 2 and 4 months We will measure the average change in heart rate between supine and standing using continuous ECG after two and four months of daily vagal nerve stimulation
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States