Abstract P065: Pacemaker Tapping Maneuver in the Treatment of Orthostatic Hypotension
A 77 year old man was referred to us with fainting spells especially after standing/walking few steps. Initially he went to a neurologist and ENT specialist where the cause could not be determined and symptoms continued. During annual physical, he noticed that his blood pressue dropped when he stood up suddenly. He had severe fainting spells and was placed pacemaker in him.However,pacemaker did not make a huge difference.Blood Pressure monitoring was done and noticed 50 mmHg drop upon standing. Pacemaker was changed to constant pacing where his dizziness continued but he had no falls. He had periodic vision problems, numbness in fingers and legs, digestive problems, stomach issues and balance problems. His tilt table test showed orthostatic hypotension.
Medical management (florinef, mestinone, midodrine) did not relieve his symptoms .Pacemaker sensor was turned on and made more sensitive that after he taps on the pacemaker, heart rate increases for 10 minutes. We told him to tap on pacemaker whenever he is dizzy and see if there is any improvement in orthostatic symptoms. The later treatment had made a huge difference; he is practically asymptomatic and was very much satisfied with his current health. He is using the tapping maneuver 4-5 times a day and his fainting disappeared and no syncope.
First time our case report on Pacemaker tapping demonstrated significant improvement in treating symptoms of orthostatic hypotension.
Author Disclosures: C. Ashangari: None. A. Suleman: None.
- © 2015 by American Heart Association, Inc.