Prevalence, characteristics and natural course of inappropriate sinus tachycardia

Inappropriate sinus tachycardia is a disease which is relatively rarely found and sometimes difficult to treat. Up to now it has been mostly treated with a β-blocker or verapamil. If this did not work sinus node modulation was considered. Since the relatively new selective IF-stream blocker ivabradine has been approved for the therapy of chronic stable angina pectoris, a new therapeutic option is available. As ivabradine is well tolerated and only few side effects are known, it may become a new therapeutic step between medication and the invasive sinus node modulation. We report the case of a young female patient with inappropriate sinus tachycardia where a sustained therapeutic success was achieved with ivabradine medication as an alternative therapeutic trial after various ineffective medications.

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“…The inappropriate sinus tachycardia causes elevated heart reates [1, 2]. According to this, the standard therapy is a betablocker medication.…”

Section: Introductionmentioning

confidence: 99%

Ivabradine as an Alternative Therapeutic Trial in the Therapy of Inappropriate Sinus Tachycardia

Schulze¹,

Steiner²,

Hennersdorf³

et al. 2007

Cardiology

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“…No specific heart rate best defines IST, yet patients with IST generally have resting daytime sinus rates of more than 100 beats/min and average 24-h heart rates of more than 90 beats/min that are not explained by physiologic demands or conditions known commonly to increase heart rate [6][7][8][9][10]. Invasive testing, such as electrophysiology studies, is not useful for making the diagnosis, although it may be useful to exclude the presence of a supraventricular tachycardia mechanism [11].…”

Section: Discussionmentioning

confidence: 99%

The Choice Of Optimal Coronary Stents: Is It Possible To Maximize Cost-Effectiveness?

Gupta¹

2016

JCTCD

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“…Although the mechanism of IST is not entirely clear, enhanced automaticity of the sinus node, altered sympathovagal balance, and impaired barorefl ex sensitivity are some of the proposed mechanisms. [52][53][54] …”

Section: Orthostatic Hypotension (Oh)mentioning

confidence: 99%

Evaluation and Management of Syncope

Bindra

Marchlinski

Lin

2008

Clinical medicine. Circulatory, respiratory and pulmonary medic

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Context Syncope is a commonly encountered by primary care physicians and cardiologists. Etiology is frequently not apparent, and patients may undergo unnecessary tests. Treatment must be tailored to the likely etiology. Complexities of diagnosis and treatment often warrant referral to a specialist. Objective To highlight the evolving recommendations for managing syncope in a clinically and cost effective manner. Evidence Acquisition An electronic literature search was undertaken of the Medline database from January 1996 to April 2006, using the Medical Subject Heading syncope, defibrillators, pacemakers, echocardiogram, cardiomyopathy, long QT syndrome, Arrhythmogenic right ventricular dysplasia, and Brugada syndrome. Abstracts and titles were reviewed to identify English-language trials. Bibliographies from the references as well as scientific statements from the Heart Rhythm Society, American Heart Association, and American College of Cardiology were reviewed. Evidence Synthesis A methodical approach to syncope can improve diagnosis, limit testing, and identify patients at risk of fatal outcome. A thorough history, physical exam and electrocardiogram are critical to the initial diagnosis. Presence of heart disease determines the extent of work-up and treatment. A trans-thoracic echocardiogram should be performed in patients with an unclear diagnosis and a positive cardiac history or an abnormal ECG. Ventricular arrhythmias are the most common cause of syncope in patients with structural heart disease. Patients with an ejection fraction less than 30 percent should receive an implantable defibrillator with few exceptions. An electrophysiology study may assist risk stratification in syncopal patients with borderline ventricular function. In patients without structural heart disease, the presence of a well defined arrhythmia syndrome consistent with a genetically determined risk of sudden death must be sought. The 12-lead electrocardiogram, family history and clinical presentation will identify most high-risk patients. Patients without structural heart disease can often be managed conservatively with well defined strategies for preventing neurocardiogenic syncope. Conclusions Managing syncope requires a methodical approach. An understanding of the limitations of the diagnostic tools and treatments is important. Lethal causes of syncope make it imperative to recognize the appropriate timing of referring patients to specialists.

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Prevalence, characteristics and natural course of inappropriate sinus tachycardia

Abstract: The prevalence of IST in a middle-aged population was higher than previously assumed. Despite the chronic nature of the disorder, the prognosis of IST was benign. The causal relationship between IST and hypertension and/or hostile personality type remains speculative.

Cited by 118 publications

References 36 publications

Ivabradine as an Alternative Therapeutic Trial in the Therapy of Inappropriate Sinus Tachycardia

Ivabradine as an Alternative Therapeutic Trial in the Therapy of Inappropriate Sinus Tachycardia

The Choice Of Optimal Coronary Stents: Is It Possible To Maximize Cost-Effectiveness?

Evaluation and Management of Syncope

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