Clinical presentation of inappropriate sinus tachycardia and differential diagnosis
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- 作者：Michael Peyrol ; Samuel Lévy
- 刊名：Journal of Interventional Cardiac Electrophysiology
- 出版年：2016
- 出版时间：June 2016
- 年：2016
- 卷：46
- 期：1
- 页码：33-41
- 全文大小：1,367 KB
- 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Cardiology - 出版者：Springer Netherlands
- ISSN：1572-8595
- 卷排序：46
文摘
Inappropriate sinus tachycardia (IST) is a syndrome characterized by a sinus tachycardia not related to a medical condition, to a physiological response, or to medication or drugs and associated with symptoms, often invalidating and altering the quality of life of affected patients. It occurs predominantly in adolescents and young adults, and in the female sex. The diagnosis requires a complete work-up in order to exclude other causes of sinus tachycardia and one or several additional tests: 24-h ECG ambulatory recordings, echocardiogram, exercise testing, and autonomous nervous system assessment. It should be differentiated from the postural orthostatic tachycardia syndrome, with which it shares a number of symptoms, and other supraventricular tachycardias originating in the high right atrium. An electrophysiological study should be considered in selected cases in order to differentiate IST from other supraventricular tachycardias. The mechanism is still unclear, and possible etiologies may include intrinsic abnormality of the sinus node, autonomic dysfunction, hypersensitivity of the sinus node to catecholamines, blunted vagal system, or a combination of the above. The authors emphasize the wide spectrum of clinical presentations and the need to better define the IST and the criteria required to ascertain its diagnosis.KeywordsInappropriate sinus tachycardiaSinus rhythm24-h ambulatory ECG recordingsExercise testingSupraventricular tachycardiasVasovagal syncopeIf currentIvabradineSinus node modification