RT-158
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Inappropriate sinus tachycardia:
mechanism and therapy
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Carlo Pappone, Giuseppe Oreto*,
Adriano Salvati, Francesco Lullo, Filippo Gullotta, Stefano Bianchi, Patrizio Mazzone,
Maria Luisa Loricchio, Francesco Furlanello, Sergio Chierchia.
Cardiology Department, S. Raffaele Hospital, Milan,
*Department of Medicine and Cardiology, University of Messina, Messina, Italy
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Definition
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Inappropriate sinus tachycardia (IST) is a chronic
non-paroxysmal tachycardia arising from the sinus node, and is characterized by a sinus
rate that is excessive with respect to the level of physical or psychological stress.
Apart from early contributions given by Codvelle and Boucher1
in 1939 and by Wising2 in 1941, the first clinical
report dedicated to this particular arrhythmia was published in 1979 by Bauernfeind et al3. Although the concept of IST is obvious, there is no
agreement on the quantitative criteria required for the diagnosis. This has resulted in
substantial differences between published series of patients: for example all
Bauernfeind's patients had resting sinus rate > 1003,
whereas 5 out of 6 patients reported by Morillo et al4
had normal resting heart rate even though reflecting an exaggerated rate response to
physical activity.
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Key Words
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Catheter ablation of supraventricular
tachyarrhythmias
inappropiate sinus tachycardia, chronic non-paroxysmal sinus tachycardia, beta-blockers,
verapamil, surgery, catheter ablation, R
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