Abstract
BACKGROUND
Limited data are available regarding the demographics, disease associations, and long-term prognosis of patients with inappropriate sinus tachycardia (IST).
OBJECTIVE
To establish epidemiologic data for patients with IST, including symptom onset, comorbid disease, and long-term outcomes.
METHODS
We retrospectively reviewed all patients with an IST diagnosis at the Mayo Clinic (Rochester, MN) during a 20-year period (1998-2018). We extracted demographic data and clinical outcomes compared to an age and gender-matched control group with atrioventricular nodal reentry tachycardia (AVNRT).
RESULTS
Within the study period, a total of 305 patients with IST were identified (mean follow-up 3.5 years) with 92.1% female and mean age 33.2 ± 11.2 years. The most frequently identified circumstances triggering the condition included pregnancy (7.9%) and infectious illness (5.9%) while the most common comorbid conditions were depression (25.6%) and anxiety (24.6%). At diagnosis, the mean left ventricular ejection fraction (LVEF) was 62.3 ± 6.2%, with 77 patients having follow-up echocardiographic data. No significant difference in LVEF was seen after a mean 4.9 ± 4.3-year follow-up (baseline LVEF 59.8 ± 10.7% vs subsequent 61.4 ± 8.1%; P = .2971). Two deaths occurred within the study period, with one related to myocardial infarction and the other noncardiac; compared to an age and gender-matched AVNRT control group there was no excess mortality during the follow-up period.
CONCLUSIONS
In our study cohort, IST predominately affects young females with structurally normal hearts and modest coexistent psychiatric disease. In most cases of IST, a major event occurring just before or at the time of diagnosis could not be identified, although nearly 8% of patients first noted symptoms during or shortly after pregnancy. In our cohort, there was no evidence of cardiomyopathy or mortality related to IST.
TY - JOUR
T1 - Natural history and clinical outcomes of inappropriate sinus tachycardia.
AU - Shabtaie,Samuel A,
AU - Witt,Chance M,
AU - Asirvatham,Samuel J,
Y1 - 2019/12/01/
PY - 2019/09/23/received
PY - 2019/10/24/revised
PY - 2019/11/16/accepted
PY - 2019/11/22/pubmed
PY - 2020/10/27/medline
PY - 2019/11/22/entrez
KW - arrhythmia
KW - inappropriate sinus tachycardia
KW - sinus tachycardia
SP - 137
EP - 143
JF - Journal of cardiovascular electrophysiology
JO - J Cardiovasc Electrophysiol
VL - 31
IS - 1
N2 - BACKGROUND: Limited data are available regarding the demographics, disease associations, and long-term prognosis of patients with inappropriate sinus tachycardia (IST). OBJECTIVE: To establish epidemiologic data for patients with IST, including symptom onset, comorbid disease, and long-term outcomes. METHODS: We retrospectively reviewed all patients with an IST diagnosis at the Mayo Clinic (Rochester, MN) during a 20-year period (1998-2018). We extracted demographic data and clinical outcomes compared to an age and gender-matched control group with atrioventricular nodal reentry tachycardia (AVNRT). RESULTS: Within the study period, a total of 305 patients with IST were identified (mean follow-up 3.5 years) with 92.1% female and mean age 33.2 ± 11.2 years. The most frequently identified circumstances triggering the condition included pregnancy (7.9%) and infectious illness (5.9%) while the most common comorbid conditions were depression (25.6%) and anxiety (24.6%). At diagnosis, the mean left ventricular ejection fraction (LVEF) was 62.3 ± 6.2%, with 77 patients having follow-up echocardiographic data. No significant difference in LVEF was seen after a mean 4.9 ± 4.3-year follow-up (baseline LVEF 59.8 ± 10.7% vs subsequent 61.4 ± 8.1%; P = .2971). Two deaths occurred within the study period, with one related to myocardial infarction and the other noncardiac; compared to an age and gender-matched AVNRT control group there was no excess mortality during the follow-up period. CONCLUSIONS: In our study cohort, IST predominately affects young females with structurally normal hearts and modest coexistent psychiatric disease. In most cases of IST, a major event occurring just before or at the time of diagnosis could not be identified, although nearly 8% of patients first noted symptoms during or shortly after pregnancy. In our cohort, there was no evidence of cardiomyopathy or mortality related to IST.
SN - 1540-8167
UR - https://www.unboundmedicine.com/medline/citation/31749258/Natural_history_and_clinical_outcomes_of_inappropriate_sinus_tachycardia_
DB - PRIME
DP - Unbound Medicine
ER -
