(P092) WAIST-HIGH COMPRESSION GARMENTS REDUCE ORTHOSTATIC TACHYCARDIA IN PATIENTS WITH POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME IN A COMMUNITY SETTING

Background: Postural orthostatic tachycardia syndrome (POTS) is a common form of orthostatic intolerance. POTS patients have excessive tachycardia, and debilitating symptoms, when upright. There are no approved medications for use in POTS. Compression garments are a non-pharmacological treatment. We have previously demonstrated a reduction in heart rate (HR) and symptoms with body compression in an acute laboratory setting, using a proof-of-principle waist-high compression garment (WHC). We sought to determine the effectiveness of commercially available WHC in a community setting (real-life environment). We evaluated acute response to compression, and response after several hours to determine if benefits are sustained over time.

METHODS AND RESULTS: POTS patients completed 4 x 10 minute standing tests with WHC (ON) and without WHC (OFF), in the morning (AM; acute effects) and afternoon after several hours of use (PM; sustained effects) on one study day (Test 1: AM-OFF, Test 2: AM-ON, Test 3: PM-ON, Test 4: PM-OFF). Test 4 was included as a PM baseline due to diurnal HR variability. A Holter monitor was provided to record HR, and participants reported Vanderbilt Orthostatic Symptom Scores (VOSS). Data are presented as mean+/-standard error and paired t-tests were used for comparisons. This study is ongoing, with 14 female participants enrolled thus far (mean age: 35+/-2 years). Prescription WHC was used by 11 participants (10-40 mmHg) and 3 participants used athletic-style WHC. Delta HR (supine to standing) was significantly reduced after 30 min of WHC use, compared to baseline without WHC (AM-ON: 26+/-3 bpm vs. AM-OFF: 39+/-4 bpm, p< 0.001). After removing the WHC after 3+ hours of use (PM-OFF), HR significantly increased compared to while wearing the WHC (PM-ON; 31+/-4 bpm vs. 22+/-3 bpm, p=0.007). VOSS symptoms were significantly reduced after 30 min of WHC use, compared to no WHC (AM-ON: 26+/-3 vs. AM-OFF: 35+/-6, p=0.007). After removing the WHC (PM-OFF), there was a significant worsening in VOSS symptoms compared to PM-ON (30+/-5 vs. 24+/-3, p=0.04).

Conclusion: This simple non-pharmacological treatment is effective in a community setting with commercially available waist-high compression garments. Orthostatic tachycardia and symptoms were reduced in patients with POTS acutely. This benefit was sustained over several hours. This builds on the prior proof-of-principle data by demonstrating use of this treatment in a real-life setting.