News | May 21, 2015

Heart Rhythm Society Addresses Three Cardiovascular Disorders Involving the Nervous System

International expert panel provides diagnosis, treatment recommendations for improved quality of care

May 21, 2015 — The Heart Rhythm Society (HRS) has released a first-of-its-kind expert consensus statement on three specific cardiovascular disorders that also involve the autonomic nervous system. The 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope was written by an international group of experts and published online in HeartRhythm Journal, the official journal of HRS. The expert consensus statement was presented at Heart Rhythm 2015, the Heart Rhythm Society’s 36th annual scientific sessions.

The expert consensus statement will help front-line cardiologists, arrhythmia specialists and other healthcare professionals to provide care for patients with postural tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), and vasovagal syncope (VVS).

  • Postural tachycardia syndrome is a clinical syndrome usually characterized by frequent symptoms like lightheadedness, palpitations, fatigue, and clouded thinking that occur when standing.
  • Inappropriate sinus tachycardia is a rapid heart rate greater than 100 beats per minute at rest and associated with distressing symptoms of palpitations.
  • Vasovagal syncope is a syndrome in which people faint, usually when sitting or standing for a while, or exposed to emotional stress, pain or medical settings.


The working group aimed to provide simple, clear insights and recommendations about the causes, diagnosis, risk stratification and treatment of these disorders, since recent advances are not widely understood by many healthcare professionals. The document provides evidence-informed recommendations, striking a balance between the need for recommendations and the availability of evidence.

“Each of these disorders causes a variety of symptoms that are challenging for patients, and their healthcare providers need to be able to make the right diagnosis and provide treatment options in a timely manner,” said task force chair and lead author of the statement, Robert S. Sheldon, M.D., Ph.D., FHRS (chair), of Libin Cardiovascular Institute of Alberta in Calgary, Canada. “Our expert consensus statement serves as an accessible, succinct resource for physicians so that diagnosis and treatment for these disorders can be more efficient, and improve both patient care and quality of life.”

The expert consensus group provided definitions and recommendations on the epidemiology and natural history, physiology, diagnosis and treatment for each disorder. Comprehensively, the document:

  1. Establishes working criteria for the diagnosis of POTS, IST and VVS;
  2. Provides guidance and recommendations on assessment and management; and
  3. Identifies key areas in which knowledge is lacking and highlights opportunities for collaborative future research efforts


The working group calls for studies to be integrated into daily clinical practice, and for future studies to be performed internationally with networks of investigators to understand the disorders better. Additionally, the group recommends integrating current and cutting-edge technologies into the investigative approaches to the syndromes.

The expert consensus statement was developed in collaboration with and endorsed by the American Autonomic Society (AAS), the American College of Cardiology (ACC), the Asia Pacific Heart Rhythm Society (APHRS), the European Heart Rhythm Association (EHRA), the Pediatric and Congenital Electrophysiology Society (PACES) and the Latin American Society of Cardiac Pacing and Electrophysiology.

For more information:

Related Content

Societies Detail Treatment for Patients With Ventricular Arrhythmias
News | EP Lab| October 30, 2017
The American College of Cardiology, along with the American Heart Association and the Heart Rhythm Society, published...
Baylis Medical and Siemens Co-Sponsor Transseptal Access Training Course
News | EP Lab| October 18, 2017
Baylis Medical Co. Inc. and Siemens Healthineers are co-sponsoring a first-of-its kind training program aimed at...
Spectranetics Initiates Class I Recall for Bridge Occlusion Balloon Catheter
News | EP Lab| September 27, 2017
Spectranetics is recalling its Bridge Occlusion Balloon Catheter due to the possibility of a blocked guidewire lumen in...
Technavio Projects 9 Percent Global Growth for Electrophysiology Therapeutic Devices

Image courtesy of Technavio

News | EP Lab| September 11, 2017
September 11, 2017 — According to the latest market study released by Technavio, the global...
Abbott. St. Jude Medical has updated its firmware to address cybersecurity issues with its Allure Quadra MP and other EP devices

Abbott. St. Jude Medical has updated its firmware to address cybersecurity issues with its Allure Quadra MP and other EP devices.

Feature | EP Lab| August 29, 2017 | Dave Fornell
August 29, 2017 — The U.S.
Ohio State Researchers Prove Human Heart's 'Battery' Has Multiple Backups
News | EP Lab| July 27, 2017
July 27, 2017 — There is good news when it comes to the heart’s sinoatrial node (SAN), the body’s natural...
Biosense webster multielectrode balloon RF ablation catheter

The Biosense Webster multi-electrode balloon RF ablation catheter. Each electrode can have varied power settings to avoid damage to underlying tissues like the esophagus. 

Feature | EP Lab| June 22, 2017 | Dave Fornell
Electrophysiology (EP) technology has been advancing rapidly the past few years with new ablation tools to improve...
Videos | EP Lab| May 26, 2017
DAIC Editor Dave Fornell takes a tour of some of the most innovative new electrophysiology (EP) technology at the 201
Videos | EP Lab| May 17, 2017
This video, provided by Spectranetics, demonstrates how to deploy the Bridge Occlusion Balloon used to seal accidenta
Spectranetics Bridge Occlusion Balloon in the SVC

An illustration of how the Bridge balloon can seal the SVC after an accidental tear from lead extration.

Feature | EP Lab| May 17, 2017 | Dave Fornell
May 17, 2017 — A new intravenous occlusion balloon designed to seal any accidental tears in the superior vena cava (S
Overlay Init