Can standing replace upright tilt table testing in the diagnosis of postural tachycardia syndrome (POTS) in the young?

The study assessed whether active standing could serve as an alternative to upright tilt table testing in diagnosing Postural Orthostatic Tachycardia Syndrome (POTS) in individuals under 19 years of age. Researchers compared the heart rate changes of adolescents with POTS to healthy controls during 5-minute active stands and 5- and 10-minute tilt tests. The results showed that heart rate increases during standing were less effective at differentiating POTS patients from controls compared to tilt testing. The sensitivity and specificity of active standing were notably lower than those of the tilt test, making it a less reliable method for diagnosing POTS in youngsters. The study concludes that tilt testing remains a superior diagnostic tool for POTS in adolescents due to its greater precision and discrimination ability.