Using Clonidine for neuromodulation in patients with postural orthostatic tachycardia syndrome
Authors' conclusion
In hyperadrenergic POTS, clonidine reduced SKNA and the low frequency/high frequency ratio. Ten participants (38%) used clonidine for > 6 months, and most (8/10, or 80%) had fewer symptoms than at baseline.
Study context
- Population
- Patients with hyperadrenergic postural orthostatic tachycardia syndrome (POTS) treated with clonidinepatients with POTS treated with clonidine, 26 completed the first recording, 10 completed follow-up recordings
- Participants
- 33 patients
- Exposure
- After clonidine vs before clonidine
- Clonidinen = 33
- Outcome
- Symptomatic episodes and 24-hour average HR, follow-up vs baseline (10 participants completing follow-up)
- Follow-up
- (6 months)
Main finding
As reported in the abstract
follow-up (6 months)
- Fewer symptomatic episodes at follow-up than at baseline
- P = .030
- Lower 24-hour average HR at follow-up than at baseline
- P = .020
Observational data: associations, not effects.
Further findings
Ratio of low frequency and high frequency SKNA · days 1-3
- Significantly decreased on days 1-3
- P = 0.001, P <.001, and P <.001, respectively
SKNA burst frequency · days 1 and 2
- Significantly reduced on day 1
- P = 0.010
- Significantly reduced on day 2
- P = 0.012
24-hour average HR · days 1-3
- Decreased significantly on days 1-3
- P = 0.005, P <.001, and P <.001, respectively
Maximum HR during the day · days 2 and 3
- Significantly decreased on day 2
- P = 0.043
- Significantly decreased on day 3
- P < 0.001
Completion of recordings
- Participants who completed the first recording
- 26 participants (24 women)
- Participants who completed the follow-up recordings
- Ten participants (38%)
Sympathetic toggled sinus rate acceleration episodes
- Patients with sympathetic toggled sinus rate acceleration episodes
- Eleven
- Sinus rate acceleration burden and duration decreased, of the 11 patients with episodes
- 7 of 11 patients (64%)
Safety
- Participants with clonidine-induced episodic bradycardia and sinus arrhythmia
- 3
Original publication
Using Clonidine for neuromodulation in patients with postural orthostatic tachycardia syndrome. Heart Rhythm. Published 6 May 2025. doi:10.
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