Comparing Propranolol and Ivabradine for treating POTS

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial investigates the effectiveness of two medications, Propranolol and Ivabradine, in treating Postural Tachycardia Syndrome (POTS), a condition characterized by an abnormal increase in heart rate upon standing. The study employs a crossover design, where participants will receive each treatment for four weeks, allowing for direct comparison of their effects on heart rate and symptoms. The primary goal is to assess which medication better alleviates the debilitating symptoms associated with POTS, such as palpitations and mental clouding. Participants will be monitored for changes in heart rate and symptom burden throughout the trial.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Diagnosis of Postural Tachycardia Syndrome
* Age between 18-60 years
* Men and women are eligible
* Able and willing to provide informed consent

Exclusion Criteria:

* Seated resting heart rate \< 70 bpm in the absence of rate-lowering medications
* Supine blood pressure \< 90/60 mmHg
* Overt cause for postural tachycardia, i.e., acute dehydration, prolonged bed rest
* Presence of underlying structural heart disease including:
* Valvular disease (i.e. moderate or greater valvular stenosis or regurgitation)
* History of heart failure
* Greater than mild left ventricular systolic impairment
* Hypertrophic cardiomyopathy
* Known coronary artery disease or prior myocardial infarction
* History of tachyarrhythmias including:
* Supraventricular tachycardia, atrial tachycardia, atrial fibrillation / flutter
* Ventricular tachyarrhythmias
* Pre-existing long QT interval (e.g. known congenital long QT syndrome, or QT interval \>500 ms)
* History of sick sinus syndrome or high degree AV block
* Presence of a pacemaker, implantable cardioverter defibrillator or cardiac resynchronization therapy device
* Diabetes mellitus or history of hypoglycemic episodes
* History of bronchospasm or uncontrolled asthma
* Pregnant (by history or serum test) or breast-feeding
* Inability to safely withdraw from existing beta-blockers or ivabradine prior to the study day
* Concomitant use of class I and III antiarrhythmic agents, or non-dihydropyridine calcium channel blockers
* Concomitant use of strong cytochrome P450 3A4 (CYP 3A4) inhibitors
* Severe hepatic impairment
* Any contraindication to propranolol or ivabradine not specifically listed above as per the product monographs.
* Unable to give informed consent

Where it's running

• University of Calgary
  Calgary, Alberta, Canada Recruiting

Study contacts

• Principal investigator: Satish R Raj, MD — University of Calgary
• Study coordinator: Satish Raj, MD
• Email: autonomic.research@ucalgary.ca
• Phone: 403-210-6152

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Stellate ganglion block to help POTS symptoms

  This study tests whether a stellate ganglion block can improve symptoms and heart rate in adults with Postural Tachycardia Syndrome compared with a sham injection.

  Recruiting at 2 sites Stanford University · Stanford, California and 1 other locations · NCT06953661

• Understanding how the brain communicates in young people with Postural Tachycardia Syndrome

  This study is testing how young people with Postural Tachycardia Syndrome understand visual information to see how their brain communicates differently compared to healthy peers.

  Recruiting Virginia Commonwealth University · Richmond, Virginia · NCT05618054

• Registry for Inappropriate Sinus Tachycardia and Postural Tachycardia Syndrome treatments

  This study is collecting information on the safety and effectiveness of AtriCure devices used to treat people with Inappropriate Sinus Tachycardia or Postural Tachycardia Syndrome.

  Recruiting at 15 sites AtriCure, Inc. · Loma Linda, California and 14 other locations · NCT05107635

• Observing autonomic neuropathies and Ehlers Danlos syndromes over time

  This study is trying to understand how autonomic neuropathies and Ehlers Danlos syndromes change over time in patients compared to healthy individuals.

  Recruiting RWTH Aachen University · Aachen, North Rhine-Westphalia · NCT04310644

• Effects of CO2 on heart rate and symptoms in POTS patients

  This study tests if breathing in higher levels of carbon dioxide can help improve heart rate and symptoms for people with Postural Orthostatic Tachycardia Syndrome (POTS).

  Recruiting University of Calgary · Calgary, Alberta · NCT04271878

• Investigating antibodies in patients with Postural Tachycardia Syndrome

  This study is testing if people with Postural Tachycardia Syndrome have more specific antibodies in their blood compared to healthy individuals, which could help us understand the condition better.

  Recruiting University of Calgary · Calgary, Alberta · NCT02673996

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.