Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 21;79(24):2450-2462.
doi: 10.1016/j.jacc.2022.04.019.

Inappropriate Sinus Tachycardia: Etiology, Pathophysiology, and Management: JACC Review Topic of the Week

Adnan Ahmed  1 , Naga Venkata K Pothineni  1 , Rishi Charate  1 , Jalaj Garg  2 , Mehmet Elbey  1 , Carlo de Asmundis  3 , Mark LaMeir  3 , Ahmed Romeya  1 , Poojita Shivamurthy  1 , Brian Olshansky  4 , Andrea Russo  5 , Rakesh Gopinathannair  1 , Dhanunjaya Lakkireddy  6
Affiliations
Free article
Review

Inappropriate Sinus Tachycardia: Etiology, Pathophysiology, and Management: JACC Review Topic of the Week

Adnan Ahmed et al. J Am Coll Cardiol. .
Free article

Abstract

Inappropriate sinus tachycardia (IST) is a clinical syndrome that generally affects young patients and is associated with distressing symptoms. Although the most common symptom is palpitations, it can be accompanied by a myriad of symptoms, including anxiety, dizziness, presyncope, and syncope. The pathogenesis of IST is not well understood and considered multifactorial, with autonomic dysfunction being the central abnormality. IST is a diagnosis of exclusion. Management presents a clinical challenge. The overall efficacy of lifestyle modifications and medical therapy may be limited. Recent advances in catheter and surgical sinus node sparing ablation techniques have led to improvement in outcomes. In addition, increased focus has led to development of multimodality team-based interventions to improve outcomes in this group of patients. In this review, we discuss the mechanistic basis of IST, review current approaches to diagnosis, and outline contemporary therapeutic approaches.

Keywords: cardiac dysautonomia; inappropriate sinus tachycardia; sinus node modification.

PubMed Disclaimer

Conflict of interest statement

Funding Support and Author Disclosures Dr Lakkireddy has been a consultant for Johnson & Johnson, Abbott, Biotronik, Pfizer, and Boston Scientific. Dr Gopinathannair has been a consultant/speaker for Abbott Medical, Boston Scientific, and Biosense Webster. Dr Olshansky has been a consultant for Sanofi; Chair of DSMB REDUCE IT–Amarin; and U.S. coordinator of GLORIA AF at Boehringer Ingelheim. Dr Russo has provided research support at Boston Scientific, Kestra, Medilynx, and Medtronic; has been a consultant for Abbott, Atricure, Biosense Webster, Boston Scientific, Medtronic, and PaceMate; has received honoraria from Biotronik, Bristol Myers Squibb/Pfizer, and Medtronic; and has received royalties from Up-to-Date. Dr LaMeier has been a consultant at Atricure. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

LinkOut - more resources