Medications, lifestyle modifications, surgical sinus node exclusion, and sinus or AV node radiofrequency catheter ablation.
Medication
Ivabradine and Beta-Blockers.
Frequency
1.16% in the general population
Inappropriate sinus tachycardia (IST) is defined as sinus tachycardia that is not caused by identifiable medical ailments, a physiological reaction, or pharmaceuticals (a diagnosis of exclusion) and is accompanied by symptoms, frequently invalidating and affecting quality of life.[2] IST symptoms include palpitations, chest discomfort, exhaustion, shortness of breath, presyncope, and syncope.[1]
While sinus tachycardia is very common and is the most common type of tachycardia, it is rare to be diagnosed with inappropriate sinus tachycardia as an independent symptom that is not part of a larger condition. Although somewhat rarely diagnosed, IST is viewed by most to be a benign condition in the long-term. Symptoms of IST, however, may be distracting and warrant treatment. The heart is a strong muscle and typically can sustain the higher-than-normal heart rhythm, though monitoring the condition is generally recommended.[3] The mechanism and primary etiology of inappropriate sinus tachycardia has not been fully elucidated. An autoimmune mechanism has been suggested, as several studies have detected autoantibodies that activate beta adrenoreceptors in some patients.[4][5] The mechanism of the arrhythmia primarily involves the sinus node and peri-nodal tissue[6] and does not require the AV node for maintenance. Treatments in the form of pharmacological therapy or catheter ablation are available, but the condition is currently difficult to treat successfully.
^Peyrol, Michael; Lévy, Samuel (September 2, 2015). "Clinical presentation of inappropriate sinus tachycardia and differential diagnosis". Journal of Interventional Cardiac Electrophysiology. 46 (1). Springer Science and Business Media LLC: 33–41. doi:10.1007/s10840-015-0051-z. ISSN 1383-875X. PMID 26329720. S2CID 23249973. Retrieved November 6, 2023.
^Olshansky, Brian; Sullivan, Renee M. (2013). "Inappropriate Sinus Tachycardia". Journal of the American College of Cardiology. 61 (8). Elsevier BV: 793–801. doi:10.1016/j.jacc.2012.07.074. PMID 23265330.
^Chiale, Pablo A.; Garro, Hugo A.; Schmidberg, Jorge; Sánchez, Rubén A.; Acunzo, Rafael S.; Lago, Manuel; Levy, Gabriela; Levin, Mariano (2006). "Inappropriate sinus tachycardia may be related to an immunologic disorder involving cardiac β andrenergic receptors". Heart Rhythm. 3 (10). Elsevier BV: 1182–1186. doi:10.1016/j.hrthm.2006.06.011. ISSN 1547-5271. PMID 17018348. Retrieved November 6, 2023.
^Nattel, Stanley (October 2006). "Inappropriate sinus tachycardia and beta-receptor autoantibodies: A mechanistic breakthrough?". Heart Rhythm. 3 (10). Elsevier BV: 1187–1188. doi:10.1016/j.hrthm.2006.07.019. ISSN 1547-5271. PMID 17018349. Retrieved November 6, 2023.
^Sato, Toshiaki; Mitamura, Hideo; Murata, Mitsushige; Shinagawa, Kaori; Miyoshi, Shunichiro; Kanki, Hideaki; Takatsuki, Seiji; Soejima, Kyoko; Miyazaki, Toshihisa; Ogawa, Satoshi (October 2000). "Electrophysiologic findings of a patient with inappropriate sinus tachycardia cured by selective radiofrequency catheter ablation". Journal of Electrocardiology. 33 (4). Elsevier BV: 381–386. doi:10.1054/jelc.2000.9648. ISSN 0022-0736. PMID 11099363. Retrieved November 6, 2023.
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