Cardiovascular exercise as a treatment for postural orthostatic tachycardia syndrome: a pragmatic treatment trial.

Background Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous disorder of orthostatic intolerance with few proven treatments. Objective The purpose of this study was to determine the efficacy of an unsupervised at-home training regimen for the treatment of POTS. Methods We reviewed the medical records including autonomic function testing, symptom scores, and activities of daily living in individuals with POTS who were invited to participate in a 6-month outpatient cardiovascular exercise program. Results Seventy-seven individuals were invited (invited group), 48 of 77 participated (treated group) and 43 of 77 of those completed. Twenty-nine of 77 did not participate (control group). After 6 months, 11 of 48 individuals in the treated group met heart rate criteria for POTS compared with 27 of 29 in the control group (χ2 test, P Conclusion In this study, we report a successful pragmatic clinical trial of an outpatient exercise protocol in a tertiary care referral population that significantly improved cardiovascular function and quality of life in patients with POTS.