Inappropriate sinus tachycardia or…something else?

Area of Science:

• Cardiology
• Electrophysiology
• Rheumatology

Background:

• A 45-year-old female with rheumatoid arthritis presented with symptoms suggestive of inappropriate sinus tachycardia.
• Initial assessment included echocardiography, revealing normal left ventricular dimensions and preserved ejection fraction.

Observation:

• A detailed review of the 12-lead electrocardiogram (ECG) suggested an alternative diagnosis of incessant atrial tachycardia.
• An electrophysiologic study utilizing an electro-anatomic mapping system was conducted for definitive diagnosis.

Findings:

• The electrophysiologic study pinpointed the source of the tachycardia to the right atrial appendage.
• Radiofrequency ablation was performed targeting the identified ectopic focus.

Implications:

• Successful radiofrequency ablation eliminated the incessant atrial tachycardia.
• The patient experienced significant improvement in symptoms following the ablation procedure.