Trial: Increased impedance to inspiration ameliorates hemodynamic changes associated with movement to upright posture in orthostatic hypotension: a randomized blinded pilot study.

Authors: Melby DP, Lu F, Sakaguchi S, Zook M, Benditt DG.

Reference: Heart Rhythm. 2007 Feb;4(2):128-35. Epub 2006 Oct 19.  PMID:  17275744

Purpose: to determine if increasing negative intrathoracic pressure by using an inspiratory impedance threshold device before change of posture diminishes blood pressure fall by enhancing venous return.

Number of Patients: 40

Number of Centers: 1

Design: Randomized, blinded

Authors Conclusion:   Enhancing impedance to inspiration may prove useful as adjunctive therapy for diminishing symptoms associated with movement to upright posture in individuals with orthostatic hypotension.

Key words:  Orthostatic hypotension; Syncope; Inspiratory impedance

Comment: An interesting potential therapy for a difficult clinical condition.  Further studies will clarify to potential role of this device.


Summary written by Robert Kowal, MD