Development and Implementation of an Interactive App to Manage Symptoms of Postural Orthostatic Tachycardia Syndrome Using Real-Time Heart Rate Monitoring

Postural Orthostatic Tachycardia Syndrome (POTS) is a type of autonomic dysfunction affecting blood circulation, marked by excessive tachycardia and orthostatic intolerance. One primary non-pharmacological management approach for POTS is pacing. Pacing involves organizing daily activities to minimize severe symptom fluctuations. Heart rate monitoring is crucial for helping POTS patients manage symptoms and implement effective pacing strategies. Optimizing daily pacing strategies using heart rate data involves understanding personal heart rate zones, tracking heart rate during different activities, and analyzing this data to adjust individual pacing strategies for improved performance and endurance. This paper details developing and implementing an interactive app to support real-time pacing strategies for POTS patients. The system is designed to identify triggers that exacerbate POTS symptoms, monitor heart rate, and provide real-time clinical suggestions for managing POTS. The app generates personalized alerts to mitigate heart rate and minimize symptom escalation by utilizing a wearable device for real-time data communication via the cloud to a decision support server using IoT architecture. The Apple Watch Series 9 was chosen to meet these requirements. The system enables the clinical team to create individualized POTS management programs, including situational suggestions, heart rate analysis parameters, and personalized alerts. A dedicated clinician website was developed to manage and communicate with patient smartwatch devices and prescribe individualized POTS self-management plans. The clinician portal supports setting up three types of alerts (situational suggestions, status checks, and email/text messaging to patients, providers, and caregivers) and reviewing collected data to adjust patients' self-management plans based on performance. Initial usability inspections through cognitive walkthroughs and heuristic evaluations indicate that the interactive POTS management app provides valuable data for adjusting activity levels, preventing overexertion, and optimizing pacing techniques for POTS patients.