A Double Blind Randomized Controlled Crossover Study to Systematically Assess the Efficacy and Safety of Intravenous Albumin Infusions in Severe Postural Orthostatic Tachycardia Syndrome
POTS is characterized by an excessive increase in heart rate and light-headedness on assuming an upright posture, standing or sitting that at times culminates in syncope. Most symptoms of POTS result from marked cardiovascular deconditioning and activation of sympathetic responses due to cerebral hypoperfusion.
Plasma volume expanding therapies are one of the mainstays of
treatment. Saline infusions in patients with severe orthostatic intolerance lead to rapid but transient symptomatic improvement lasting several hours. Human albumin infusions are used for plasma volume replacement/expansion and have been shown to significantly improve cerebral blood flow.
A small subset of patients suffering from severe POTS have shown robust response to weekly albumin therapy, supporting the investigator's hypothesis that periodic albumininfusions will provide significant and sustained symptomatic relief to patients with severe POTS. This would increase their orthostatic tolerance and improve functional capacity without the limitations and side effects associated with other therapies.