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Inappropriate sinus tachycardia.

Brian Olshansky1,2, Renee M Sullivan3

  • 1Professor Emeritus, Cardiology, University of Iowa Hospitals, 200 Hawkins Drive, Iowa, IA, USA.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|June 23, 2018
PubMed
Summary
This summary is machine-generated.

Inappropriate sinus tachycardia (IST) is a syndrome of fast heart rates without a clear cause, often causing debilitating symptoms. Diagnosis requires ruling out secondary causes, with treatments including medications like ivabradine or beta-blockers.

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Inappropriate sinus tachycardia (IST) is a clinical syndrome characterized by elevated heart rates.
  • It is defined by specific heart rate criteria and associated symptoms like palpitations.
  • The exact underlying mechanism of IST remains unclear and may be multifactorial.

Purpose of the Study:

  • To define Inappropriate Sinus Tachycardia (IST).
  • To outline diagnostic considerations for IST.
  • To review current treatment options for IST.

Main Methods:

  • Literature review of guidelines and consensus documents on IST.
  • Discussion of diagnostic criteria and exclusion of secondary causes.
  • Overview of therapeutic interventions for IST.

Main Results:

  • IST is defined by resting heart rates >100 bpm or average 24-hour rates >90 bpm, in the absence of other causes.
  • A comprehensive evaluation to exclude secondary causes of tachycardia is essential before diagnosing IST.
  • Effective treatments may include ivabradine, beta-blockers, or calcium channel antagonists, with ablation being a less common option.

Conclusions:

  • IST is a syndrome of unexplained fast sinus heart rates with associated symptoms.
  • Accurate diagnosis hinges on excluding secondary causes of tachycardia.
  • Pharmacological interventions are the mainstay of IST management.