Nicholas L DePace
Franklin Cardiovascular Associates, PA, and Autonomic Dysfunction and POTS Center, Attending Cardiologist, Pennsylvania Hospital of the University of Pennsylvania Health System, 1100 Liberty Place, Sicklerville, NJ 08081, United States
Publications
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Research Article
Improved Patient Outcomes by Normalizing Sympathovagal Balance: Midodrine and Parasympathetic and Sympathetic Monitoring
Author(s): Nicholas L DePace, Aaron I Vinik, Cesar R Acosta, Jeysel M Pinales, Michael Yayac and Joseph Colombo*
A function of the Parasympathetic and Sympathetic (P&S) nervous systems is to maintain proper tissue perfusion, including of the heart and brain upon head-up postural change standing. Orthostatic dysfunction (OD) is associated with pooling of blood in the lower extremities, insufficient vascular support of the heart, and poor brain perfusion. Abnormal P&S responses to standing help to guide therapy for the individual patient. Midodrine is often the primary recommendation to correct P&S dysfunction upon standing. P&S Monitoring (Physio PS, Inc, Atlanta, GA) differentiates OD-subtypes in 2727 cardiology patients, serially tested. P&S Monitoring non-invasively, independently, and simultaneously measures P&S activity, including the normal P-decrease followed by an S-increase with head-up postural change (standing). S-Withdrawal (SW) and P-Excess (PE) are two types .. Read More»