Utilizing Wearable Technology to Improve POTS Diagnostic Testing

Postural orthostatic tachycardia syndrome (POTS) is a form of dysautonomia characterized by a heart rate (HR) increase ≥30 beats/minute (bpm) within 10 minutes of standing from a supine position, without a significant blood pressure drop. POTS can diminish quality of life with symptoms including tachycardia, headaches, and fatigue. Despite established diagnostic criteria, POTS is often underrecognized or misdiagnosed due to its episodic nature. Symptoms may not consistently be present during diagnostic testing, leading to false negatives during in-office testing. Wearables offer a promising solution through continuous physiological monitoring. Individuals with hypermobile Ehler-Danlos Syndrome (hEDS), a population in which POTS is prevalent, wore a Corsano CardioWatch 2B for 30 days. The wearable continuously measured physiological metrics, and utilizing movement data, the time when individuals stood from bed was identified. Assuming standing from bed involves transitioning from supine to standing, it can mimic the orthostatic change during in-office assessments. Thus far, eight healthy controls and seven individuals with hEDS were analyzed. Initial findings show considerable variability in individuals’ mean HR increases, ranging from 6.60 to 27.02 bpm in healthy controls and 8.15 to 27.71 bpm in individuals with hEDS. However, there was a notable difference in step count, averaging 27 steps in individuals with hEDS and 64 steps in healthy controls, suggesting activity may contribute to HR increases in controls. Future work of incorporating activity during the period of interest may stratify hemodynamic changes and better identify group differences. These findings support the potential of wearables in advancing POTS diagnostic testing.