Heart rate variability in inappropriate sinus tachycardia

Castellanos, Agustín; Moleiro, Federico; Chakko, Simon; Acosta, Helbert; Huikuri, Heikki V.; Mitrani, Raul D.; Myerburg, Robert J.

doi:10.1016/s0002-9149(98)00373-7

Cited by 35 publications

(34 citation statements)

References 15 publications

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“…Compared with age‐ and sex‐matched controls, the authors reported a higher intrinsic HR in all patients with IST. Enhanced sinus node automaticity was thought to be potentiated by β‐adrenergic receptor hypersensitivity and impaired response to vagal stimulation . Chiale and colleagues reported the presence of β‐adrenergic receptor auto‐antibodies in 52% of patients with IST.…”

Section: Discussionmentioning

confidence: 99%

P‐Wave Amplitude and PR Changes in Patients With Inappropriate Sinus Tachycardia: Findings Supportive of a Central Mechanism

Field

Donateo

Bottoni³

et al. 2018

JAHA

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BackgroundThe mechanism of inappropriate sinus tachycardia (IST) remains incompletely understood.Methods and ResultsWe prospectively compared 3 patient groups: 11 patients with IST (IST Group), 9 control patients administered isoproterenol (Isuprel Group), and 15 patients with cristae terminalis atrial tachycardia (AT Group). P‐wave amplitude in lead II and PR interval were measured at a lower and higher heart rate (HR1 and HR2, respectively). P‐wave amplitude increased significantly with the increase in HR in the IST Group (0.16±0.07 mV at HR1=97±12 beats per minute versus 0.21±0.08 mV at HR2=135±21 beats per minute, P=0.001). The average increase in P‐wave amplitude in the IST Group was similar to the Isuprel Group (P=0.26). PR interval significantly shortened with the increases in HR in the IST Group (146±15 ms at HR1 versus 128±16 ms at HR2, P<0.001). A similar decrease in the PR interval was noted in the Isuprel Group (P=0.6). In contrast, patients in the atrial tachycardia Group experienced PR lengthening during atrial tachycardia when compared with baseline normal sinus rhythm (153±25 ms at HR1=78±17 beats per minute versus 179±29 ms at HR2=140±28 beats per minute, P<0.01).ConclusionsWe have shown that HR increases in patients with IST were associated with an increase in P‐wave amplitude in lead II and PR shortening similar to what is seen in healthy controls following isoproterenol infusion. The increase in P‐wave amplitude and absence of PR lengthening in IST support an extrinsic mechanism consistent with a state of sympatho‐excitation with cephalic shift in sinus node activation and enhanced atrioventricular nodal conduction.

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Section: Discussionmentioning

confidence: 99%

P‐Wave Amplitude and PR Changes in Patients With Inappropriate Sinus Tachycardia: Findings Supportive of a Central Mechanism

Field

Donateo

Bottoni³

et al. 2018

JAHA

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“…There are multiple measures of cardiovascular autonomic reflexes, including heart rate responses to deep breathing, standing, Valsalva, 57,58 cold face test (diving test), 59 heart rate variability, 59,60 and baroreflex sensitivity. 61 These tests should not be used routinely given their unproven clinical usefulness.…”

Section: Section 2: Inappropriate Sinus Tachycardia Definitionmentioning

confidence: 99%

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

et al. 2015

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“…Inappropriate sinus tachycardia (IST) is characterized by a usual resting heart rate (HR) greater than 100 beats per min (bpm) or a HR disproportionally greater than biological need, associated with symptoms that can be debilitating. IST is a diagnosis of exclusion, requiring that other causes of sinus tachycardia be investigated.…”

Section: Introductionmentioning

confidence: 99%

Epicardial/Endocardial Sinus Node Ablation After Failed Endocardial Ablation for the Treatment of Inappropriate Sinus Tachycardia

Jacobson

Kraus

Lee

et al. 2013

Cardiovasc electrophysiol

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Heart rate variability in inappropriate sinus tachycardia

Cited by 35 publications

References 15 publications

P‐Wave Amplitude and PR Changes in Patients With Inappropriate Sinus Tachycardia: Findings Supportive of a Central Mechanism

P‐Wave Amplitude and PR Changes in Patients With Inappropriate Sinus Tachycardia: Findings Supportive of a Central Mechanism

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

Epicardial/Endocardial Sinus Node Ablation After Failed Endocardial Ablation for the Treatment of Inappropriate Sinus Tachycardia

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