The Experts below are selected from a list of 906 Experts worldwide ranked by ideXlab platform
Samuel J Asirvatham - One of the best experts on this subject based on the ideXlab platform.
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abstract 9800 natural history and clinical outcomes of Inappropriate Sinus Tachycardia the mayo clinic experience
Circulation, 2019Co-Authors: Samuel A Shabtaie, Chance M Witt, Samuel J AsirvathamAbstract:Introduction: Very limited data is known regarding the demographics, disease associations and long-term prognosis of patients with Inappropriate Sinus Tachycardia (IST). Methods: We retrospectively...
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refractory Inappropriate Sinus Tachycardia successfully treated with radiofrequency ablation at the arcuate ridge
Heart Rhythm, 2012Co-Authors: Ammar M Killu, Faisal F Syed, Samuel J AsirvathamAbstract:Supraventricular Tachycardias similar to Sinus rhythm are difficult to evaluate and treat with catheter ablation. In addition to Inappropriate Sinus Tachycardia (IST), curative ablation of atrial Tachycardia arising from the crista terminalis is well described. We report the case of a 48-year-old woman with multiple failed ablation attempts for IST successfully ablated on the arcuate ridge. Ultrasound and fluoroscopy-guided mapping and ablation of this specific endocavitary anatomic site may be helpful in certain patients with the diagnosis of IST.
Sharon Rubin - One of the best experts on this subject based on the ideXlab platform.
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Inappropriate Sinus Tachycardia in a transplanted heart further insights into pathogenesis
Heart Rhythm, 2011Co-Authors: Matthew Ortman, Paul J. Mather, Sharon RubinAbstract:Inappropriate Sinus Tachycardia (IST) is relatively uncommon and poorly understood. Proposed mechanisms include sympathovagal imbalance or a primary Sinus node (SAN) abnormality. We report a case of IST in a transplanted heart refractory to pharmacological therapy and causing severe allograft dysfunction. Secondary causes of Sinus Tachycardia were excluded. Cardiomyopathy resolved with heart rate (HR) control by SAN modification and -blocker therapy. The occurrence of IST in a completely denervated heart excluded a sympathovagal mechanism and implicated a primary defect in the donor SAN.
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Inappropriate Sinus Tachycardia in a transplanted heart—Further insights into pathogenesis
Heart rhythm, 2010Co-Authors: Matthew Ortman, Paul J. Mather, Sharon RubinAbstract:Inappropriate Sinus Tachycardia (IST) is relatively uncommon and poorly understood. Proposed mechanisms include sympathovagal imbalance or a primary Sinus node (SAN) abnormality. We report a case of IST in a transplanted heart refractory to pharmacological therapy and causing severe allograft dysfunction. Secondary causes of Sinus Tachycardia were excluded. Cardiomyopathy resolved with heart rate (HR) control by SAN modification and -blocker therapy. The occurrence of IST in a completely denervated heart excluded a sympathovagal mechanism and implicated a primary defect in the donor SAN.
Carlos A. Morillo - One of the best experts on this subject based on the ideXlab platform.
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Inappropriate Sinus Tachycardia: current therapeutic options.
Cardiology in review, 2012Co-Authors: Francisco Femenía, Adrian Baranchuk, Carlos A. MorilloAbstract:Inappropriate Sinus Tachycardia (IST) is an uncommon form of arrhythmia characterized by an increased heart rate that is out of proportion to a normal physiologic demand. The etiology of IST remains ill-defined and controversial. Clinical presentation of IST is highly variable, from isolated to sustained palpitations, and can cause deterioration in one's quality of life. IST is usually a diagnosis of exclusion and it is important to rule out other causes of Sinus Tachycardia before reaching a final diagnosis. evaluation of cardiac auto- nomic reflex function is essential to support the diagnosis of IST. The treatment of IST aims to target the multiple mechanisms involved in this disease, and multidisciplinary management, including cardiac rehabilitation, pharmacother - apy, and occasionally radiofrequency modification of the Sinus node, should be considered. The prognosis is usually benign, although regular follow-up is required to optimize therapy and prevent the onset of tachycardiomyopathy.
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Inappropriate Sinus Tachycardia: an update
Revista espanola de cardiologia, 2007Co-Authors: Carlos A. Morillo, Juan C. GuzmanAbstract:Inappropriate Sinus Tachycardia (IST) is an uncommon form of arrhythmia which is characterized by an exaggerated increase in heart rate that is out of proportion to normal physiologic demands. Usually, IST is triggered by orthostasis, minimal exertion, and psychological stress. The etiology of IST remains ill-defined. However, proposed mechanisms include: enhanced Sinus node automaticity, alterations in autonomic function associated with increased sympathetic activity or reduced parasympathetic activity, and impaired baroreflex control. Recently, increased levels of autoantibodies to beta-adrenergic receptors have been observed in patients with IST. The clinical presentation of IST is highly varied and ranges from short episodes of palpitations associated with dyspnea, atypical precordial pain, cephalalgia, fatigue, and occasional syncope and presyncope to incapacitating incessant Tachycardia. In general, IST is a diagnosis of exclusion. It is important that other causes of Sinus Tachycardia are excluded before making a diagnosis. Evaluation of autonomic function is essential for a diagnosis of IST. Treatment of IST is based on autonomic function findings and involves multidisciplinary management, including cardiac rehabilitation. Control and restitution of normal autonomic function is essential. The prognosis is benign though regular follow-up is required to optimize therapy.
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Impaired baroreflex gain in patients with Inappropriate Sinus Tachycardia.
Journal of cardiovascular electrophysiology, 2005Co-Authors: Hernando Leon, Juan Camilo Guzman, Tom Kuusela, Rejane Dillenburg, Mark V. Kamath, Carlos A. MorilloAbstract:Impaired Baroreflex Gain and Inappropriate Sinus Tachycardia. Introduction: The aim of this study was to determine the characteristics of heart rate variability (HRV), blood pressure variability (BPV), and baroreflex gain(BRG) at rest and during orthostatic stress in patients with clinical criteria of Inappropriate Sinus Tachycardia (IST). Methods and Results: Beat-to-beat HRV and BPV, measured by time- and frequency-domain methods, and noninvasive BRG, calculated by cross-spectral analysis, were obtained during 10 minutes both at rest and during the stabilization phase (5-15 min) of orthostatic stress at 60° in 8 patients with clinical criteria of IST and 9 healthy volunteers (CON). IST patients had a higher resting mean heart rate (78.8 ′ 5.3 vs 58.5 ′ 4.2 beats/min, P = 0.01) and mean blood pressure (90.4 ′ 2.4 vs 72.0 ′ 4.2 mmHg; P = 0.002). RMSSD, pNN50m, and BRG were significantly reduced in IST patients at rest. BRG during orthostatic stress (7.2 ′ 0.8 vs 20.3 ( 2.4 ms/mmHg, P < 0.01) was significantly reduced in IST patients. Δ BRG (-16.9% ′ 11 vs - 50.1% ′ 5, P = 0.02) was markedly blunted during orthostatic stress in IST patients. Conclusion: BRG was markedly impaired both at rest and during orthostatic stress in IST patients. This alteration may be responsible for the higher resting heart rate and mean blood pressures seen at rest and may facilitate Tachycardia during orthostatic stress. A primary alteration in Sinus node automaticity coupled with impaired BRG determines heart rate response to orthostatic stress in patients with IST.
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Is Inappropriate Sinus Tachycardia Really Inappropriate
Cardiac Arrhythmias 2001, 2002Co-Authors: Carlos A. Morillo, Hernando Leon, F. PavaAbstract:“Inappropriate Sinus Tachycardia” is a poorly defined clinical syndrome characterized by an increased resting Sinus rate or an Inappropriate and exaggerated acceleration of heart rate with minor physiological or emotional stress. Patients with Inappropriate Sinus Tachycardia have a wide spectrum of clinical manifestations that range from mild palpitations to severely symptomatic incessant Tachycardia [1]. Additionally, the clinical manifestation of orthostatic intolerance, primarily by severe Tachycardia provoked by orthostatic changes, may also be associated with presyncope and syncope. These features have raised the possibility that Inappropriate Sinus Tachycardia is more likely to be an alteration of autonomic response to orthostatic stress than a primary Sinus node alteration.
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mechanism of Inappropriate Sinus Tachycardia role of sympathovagal balance
Circulation, 1994Co-Authors: Carlos A. Morillo, George J. Klein, Ranjan K Thakur, Marco Zardini, Raymond YeeAbstract:BACKGROUND"Inappropriate" Sinus Tachycardia (IST) is an uncommon and poorly defined atrial Tachycardia characterized by Inappropriate Tachycardia and exaggerated acceleration of heart rate with "normal" P wave. The mechanism of this Tachycardia is unknown. The purpose of the present study was to determine the role of autonomic balance in the genesis of IST.METHODS AND RESULTSSix female patients aged 23 to 38 years with IST and 10 age- and sex-matched control subjects were assessed with the following autonomic function tests: (1) sympathovagal balance to the Sinus node assessed by calculating the LF/HF (low frequency/high frequency) ratio using power spectral analysis both in the supine position and after 10 minutes of head-up tilt to 60 degrees, (2) cardiovagal reflex assessed by cold face test (CFT), (3) beta-adrenergic sensitivity as determined by calculating isoproterenol dose-response curves and isoproterenol chronotropic dose 25 (CD25), and (4) intrinsic heart rate (IHR) assessed after autonomic bloc...
Jeffrey V. Garrett - One of the best experts on this subject based on the ideXlab platform.
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Partial Cardiac Denervation and Sinus Node Modification for Inappropriate Sinus Tachycardia
The Annals of thoracic surgery, 2007Co-Authors: Tsuyoshi Taketani, Randall K. Wolf, Jeffrey V. GarrettAbstract:We describe a case of Inappropriate Sinus Tachycardia refractory to medical therapy and catheter Sinus node ablation, which was successfully treated by surgery with approaches on both the Sinus node and cardiac autonomic ganglia.
Shaojie Chen - One of the best experts on this subject based on the ideXlab platform.
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case report renal sympathetic denervation as a tool for the treatment of refractory Inappropriate Sinus Tachycardia
Medicine, 2015Co-Authors: Marcio Galindo Kiuchi, Hanry Barros Souto, Tetsuaki Kiuchi, Shaojie ChenAbstract:Inappropriate Sinus Tachycardia is defined as Sinus Tachycardia at rest (heart rate ≥100 bpm) in sitting position or/and as an average heart rate ≥90 bpm during 24-hour Holter monitoring. The most common symptoms are palpitation, dizziness, chest discomfort, orthostatic intolerance, and fatigue. Sometimes, the symptoms can be severe and debilitating, and its etiology is not well understood. Pharmacological approaches present limitation because of their relatively small effectiveness, intolerance, or side effects. In this series of cases of Inappropriate Sinus Tachycardia, the authors report 3 cases refractory to conventional pharmacological therapy, in which the authors were not tempted for ablation of the Sinus node. The authors, however, use another therapeutic approach, which was renal sympathetic denervation, to reduce sympathetic activity in the Sinus node, and consequently reduce Tachycardia with improvement of symptoms. Three months after renal sympathetic denervation, all patients were not using any type of medication, and reported no more symptoms. The authors know that this is the first report using the renal sympathetic denervation for the treatment of Inappropriate Sinus Tachycardia. Studies with a larger number of patients, a longer time of follow-up, and a control group, however, should be performed.
