ST-segment changes during tilt table testing for postural tachycardia syndrome: correlation with exercise stress test results

  • Ramya Vajapey
  • Erika Hutt Centeno
  • Erik H. Van Iterson
  • Haitham M. Ahmed
  • Kenneth A. MayugaEmail author
Short Communication



Prior studies have reported ECG (Electrocardiogram) changes during tilt table testing (TTT), specifically during repolarization with ST-segment and T-wave changes. The correlation with ischemic evaluation remains unclear. The purpose of this study was to analyze the prevalence of ST-segment changes during TTT in a young, otherwise healthy population of patients with postural tachycardia syndrome (POTS), and correlate them with exercise stress test results.


Two hundred and fifty-five patients with POTS who underwent TTT and an exercise treadmill test (ETT) were analyzed.


Forty-five had ST-segment changes/depressions during TTT (91% female, average age 36 years). Of the 45, three had ST-segment depression during ETT; all three had negative exercise stress echocardiograms (ESEs). Two others had ST-segment depressions on ETT (but not TTT), with negative ESEs.


In a cohort of young, female, otherwise healthy patients with POTS, ST-segment changes occurred in a significant portion (18%) of patients during TTT. When evaluated with exercise stress testing, these patients had no evidence of underlying ischemia on ETT or ESE.


Tilt table test Postural tachycardia syndrome Electrocardiogram Exercise stress test 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019
corrected publication on september 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular Medicine, Section of Cardiac Electrophysiology and PacingCleveland ClinicClevelandUSA

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