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==Diagnosis==
==Diagnosis==
== Treatment ==
== Treatment ==
Treatments in the form of [[pharmacological]] therapy or [[catheter ablation]] are available, although it is currently difficult to treat successfully.


===Beta-blockers===
In so far as the pathophysiology of IST involves abnormal sensitivity to [[adrenaline]], [[betaa-blockers]] can be helpful.
===Calcium Channel Blockers===
Although [[calcium channel blockers]] slow conduction through the [[AV node]], they have been marginally effective in the treatment of IST.
===Ivabradine===
A new selective sinus node inhibitor [[Ivabradine]] is also being used to treat IST.
===Treatments Related to Dysautonomia and POTS===
In so far as the underlying pathophysiology may involve a [[dysautonomia]] and features of [[Postural orthostatic tachycardia syndrome]] ([[POTS]]), some therapies more commonly used to treat these disorders have been tried:
====[[Fludrocortisone]] ([[Florinef]])====
[[POTS]] and [[dysautonomia]] have been associated with decreases in blood volume, and this drug promotes sodium retention.
====[[Midodrine]]====
Midodrine increases vasoconstriction, and prevents falls in blood pressure.
====[[Serotonin-reuptake inhibitors]] ([[SSRI]]s)====
SSRIs have proven effective in treating some patients with [[dysautonomia]].


===Catheter Ablation===
===Catheter Ablation===

Revision as of 12:42, 10 September 2012

Inappropriate sinus tachycardia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: IST; chronic nonparoxysmal sinus tachycardia

Overview

Historical Perspective

Pathophysiology

Epidemiology and Demographics

Differentiating Inappropriate Sinus Tachycardia from other Medical Conditions

Differentiating Inappropriate Sinus Tachycardia from other Supraventricular Arrhythmias

Diagnosis

Treatment

Catheter Ablation

Invasive treatments include forms of Catheter ablation has gained favor among electrophysiologists in the treatment of IST.

Sinus Node Modification

This procedure involves selective ablation of the sinus node. The rhythm reoccurs in 80% of cases.

Complete Sinus Node Ablation

This procedure requires implantation of a Permanent Artificial pacemaker)

AV Node Ablation

In cases resistant to sinus node ablation, AV node ablation with creation of an iatrogenic complete heart block, may be neccessary. This procedure requires implantation of a permanent artificial pacemaker.

See also

References



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