Natural history and clinical outcomes of inappropriate sinus tachycardia

Samuel A. Shabtaie, Chance M. Witt, Samuel J. Asirvatham

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of cardiovascular electrophysiology
DOIs
StateAccepted/In press - Jan 1 2019

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Sinus Tachycardia
Natural History
Atrioventricular Nodal Reentry Tachycardia
Stroke Volume
Demography
Pregnancy
Control Groups
Mortality
Cardiomyopathies
Psychiatry
Cohort Studies
Research Design
Anxiety
Myocardial Infarction
Depression

Keywords

  • arrhythmia
  • inappropriate sinus tachycardia
  • sinus tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Natural history and clinical outcomes of inappropriate sinus tachycardia. / Shabtaie, Samuel A.; Witt, Chance M.; Asirvatham, Samuel J.

In: Journal of cardiovascular electrophysiology, 01.01.2019.

Research output: Contribution to journalArticle

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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.",
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