December 1, 1995Journal of Cardiovascular Electrophysiology111 citations
View Full PaperInappropriate Sinus Tachycardia: Evaluation and Therapy
Key Result
Inappropriate sinus tachycardia is a clinical syndrome most common in young females, treated empirically with beta blockers, verapamil, or radiofrequency catheter ablation for refractory symptoms.
Structured PICO
P
Population
Patients with inappropriate sinus tachycardia (most common in young females without underlying structural heart disease)
I
Intervention
Pharmacologic therapy (beta blockers or verapamil) or radiofrequency catheter ablation of the superior portion of the sinus node
This review outlines the evaluation and empiric management strategies, including pharmacotherapy and ablation, for inappropriate sinus tachycardia.
Abstract
Inappropriate sinus tachycardia is an ill-defined clinical syndrome characterized by an increased resting heart rate accompanied by an exaggerated response to exercise or stress. It is not associated with underlying structural heart disease. The mechanism may involve a primary abnormality of the sinus node demonstrating enhanced automaticity or, alternatively, a primary autonomic disturbance with increase sympathetic activity and enhanced sinus node beta-adrenergic sensitivity. The diagnosis of inappropriate sinus tachycardia is one of exclusion. It is most common in young females, with a disproportionate number employed in the health care field. Autonomic and electrophysiologic testing may be required in selected individuals to clarify the mechanism and rule out sinus node reentry or right atrial tachycardia. Therapy of inappropriate sinus tachycardia is empiric. Pharmacologic approaches include beta blockers or verapamil. Radiofrequency catheter ablation of the superior portion of the sinus node shows promise as a useful alternative in patients with refractory symptoms.