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Treatment For Inappropriate Sinus Tachycardia

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ABSTRACT
Inappropriate Sinus Tachycardia is a chronic medical condition with a wide variety of clinical presentations making it, sometimes, very insidious at the time of the diagnosis. Several therapeutic options including, pharmacotherapy, cardiac rehabilitation and modification or ablation of the sinus node have been proposed for the management of Inappropriate Sinus Tachycardia. But due to the complexity and not well understood pathophysiology, it can be difficult to manage despite the numerous treatment options currently available. The purpose of this review is to analyze the treatment for Inappropriate Sinus Tachycardia focusing on the role of newer therapy and the potential benefits in the management of this cardiac rhythm …show more content…

[4]
The clinical presentation of patients with IST can vary due to the diversity of its multiple symptoms including: intermittent palpitations, dyspnea, dizziness, lightheadedness, pre-syncope, syncope, chest pain, myalgia, and fatigue. [12] Associated psychological and emotional problems can also be seen, but no relationship with IST has been identified. [8]
Using a criteria of a resting heart rate >100 bpm and an average heart rate of >90 bpm on 24-hour Holter monitoring, Still et al., estimated the prevalence of IST in a middle-aged population of men and women. The IST prevalence was 1.2% (7 of 604 patients) [2], including both symptomatic and asymptomatic patients. IST has also been reported in older population. [5] Although, IST is believed to be a chronic condition, long-term complications are few. IST has been associated with tachycardia-induced cardiomyopathy in isolated cases [6][7] and no mortality has been yet reported.
IST is a medical entity that should be diagnosed by exclusion, medical history and physical examination and should be assessed thoroughly, aiming to the potential causes of sinus tachycardia, thus, thyroid disease, medications, hypovolemia, panic attacks, anxiety and substance abuse should be ruled out. A 12-lead EKG is useful for recording tachycardia and defining sinus rhythm, which helps differentiate IST from

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