Clinical Autonomic Research

, Volume 18, Issue 1, pp 36–39

Postural tachycardia syndrome with asystole on head-up tilt

  • Amer Alshekhlee
  • Meziane Guerch
  • Faisal Ridha
  • Kevin Mcneeley
  • Thomas C. Chelimsky


Enhanced sympathetic activity causes an exaggerated heart rate response to standing in the postural tachycardia syndrome (POTS). All patients describe symptoms of orthostatic intolerance such as dizziness, blurred vision, shortness of breath, palpitations, tremulousness, chest discomfort, headache, lightheadedness and nausea, but only one third suffer loss of consciousness. We report four patients with POTS, who had long ventricular pauses (i.e. asystole) and syncope during head-up tilt test. This suggests that a subset of patients with POTS can have a surge in parasympathetic outflow that precedes vasovagal syncope.


asystole postural tachycardia syndrome heart rate head-up tilt syncope autonomic nervous system 


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Copyright information

© Springer 2008

Authors and Affiliations

  • Amer Alshekhlee
    • 1
    • 2
  • Meziane Guerch
    • 1
  • Faisal Ridha
    • 1
  • Kevin Mcneeley
    • 1
  • Thomas C. Chelimsky
    • 1
  1. 1.Autonomic Laboratory, Neurological InstituteUniversity Hospitals Case Medical CenterClevelandUSA
  2. 2.Neurological InstituteUniversity Hospitals Case Medical Center, Case Western Reserve UniversityClevelandUSA

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