scholarly journals Clinical and Laboratory Improvement in Hyperadrenergic Postural Orthostatic Tachycardia Syndrome (POTS) after COVID-19 Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Rebecca A. Ocher ◽  
Erika Padilla ◽  
Jonathan C. Hsu ◽  
Pam R. Taub
Keyword(s):  
Heart Rate ◽  
Sinus Tachycardia ◽  
Symptomatic Improvement ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Av Block ◽  
Event Monitoring ◽  
Inappropriate Sinus Tachycardia ◽  
History Of ◽  
The Impact ◽  
Catecholamine Levels

A 32-year-old woman with a history of symptomatic supraventricular tachycardia, inappropriate sinus tachycardia, and hyperadrenergic POTS was treated with ivabradine and metoprolol. She then presented with bradycardia and Mobitz II second-degree AV block on event monitoring six weeks after COVID-19 infection. Her post-viral workup revealed normalization of catecholamine levels and significant symptomatic improvement in heart rate. To the authors’ knowledge, this is the first reported case of improvement in POTS after COVID-19 infection. As our understanding of COVID-19 continues to improve, it will be vital to better understand the impact of COVID-19 dysautonomia on cardiac patients.

scholarly journals Heart rate increase and inappropriate sinus tachycardia after cryoballoon pulmonary vein isolation for atrial fibrillation

2021 ◽  
Author(s):  
C. van Deutekom ◽  
B. A. Mulder ◽  
H. F. Groenveld ◽  
R. G. Tieleman ◽  
A. C. P. Wiesfeld ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Sinus Tachycardia ◽  
Rate Increase ◽  
Holter Monitoring ◽  
Entire Group ◽  
Inappropriate Sinus Tachycardia ◽  
History Of

Abstract Background Cryoballoon pulmonary vein isolation (PVI) is a common therapy for atrial fibrillation (AF). While moderately increased sinus rhythm heart rate (HR) after PVI has been observed, inappropriate sinus tachycardia (IST) is a rare phenomenon. We aimed to investigate the prevalence and natural history of an abnormal sinus HR response after cryoballoon PVI. Methods We included 169/646 (26.2%) patients with AF undergoing PVI with available Holter recordings before and 3, 6 and 12 months after the procedure. Patients with AF on Holter monitoring were excluded. Mean HR increase ≥ 20 bpm or an IST-like pattern (mean HR > 90 bpm or > 80 bpm when beta-blocking agents were used) following PVI was categorised as abnormal sinus HR response. Results Following PVI, mean HR ± standard deviation increased in the entire group from 63.5 ± 8.4 to 69.1 ± 9.9 bpm at 3 months (p < 0.001), and to 71.9 ± 9.4 bpm at 6 months (p < 0.001). At 12 months, mean HR was 71.2 ± 10.1 bpm (p < 0.001). Only 7/169 patients (4.1%) met criteria for abnormal sinus HR response: mean HR was 61.9 ± 10.6 bpm (pre-ablation), 84.6 ± 9.8 bpm (3 months), 80.1 ± 6.5 bpm (6 months) and 76.3 ± 10.1 bpm (12 months). Even at 12 months, mean HR was significantly different from that pre-ablation in this group (p = 0.033). However, in patients meeting IST-like pattern criteria, mean HR at 12 months was no longer significantly different from that pre-ablation. Conclusion Few patients had an abnormal sinus HR response after PVI. Peak HR was observed 3 months after PVI, but HR was still significantly increased 12 months post-ablation compared with pre-ablation. An IST-like pattern was rarely observed. In these patients, HR decreased to pre-ablation values within a year.

NORMOCARDIA – CORRECT HEART RHYTHM

2020 ◽  
Vol 2 (55) ◽  
pp. 34-38
Author(s):  
Przemysław Mitkowski
Keyword(s):  
Sinus Tachycardia ◽  
Heart Rhythm ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Inappropriate Sinus Tachycardia ◽  
P Waves ◽  
Sinus Rate ◽  
Pr Interval ◽  
Esc Guidelines ◽  
The Difference ◽  
Rate Limit

Sinus rhythm is diagnosed based on 12-lead ecg recording. Diagnostic criteria are as follows: positive P waves in limb lead I and II and negative in aVR; PR interval of at least 120 ms; the difference of consecutive P-P interval should be less than 120 ms. A sinus rate limit is between 50-100/min. Numerous factors: physiologic, pathologic, medications, drugs and stimulants could increase sinus rate. Sinus tachycardia is also observed in inappropriate sinus tachycardia and postural orthostatic tachycardia syndrome. ESC guidelines related to latter two syndrome are summarized.

P1096Cardioneuroablation changes the type of vaso-vagal response in patients with asystolic reflex syncope

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
R Piotrowski ◽  
A Zuk ◽  
J Baran ◽  
A Sikorska ◽  
T Krynski ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Postgraduate Medical Education ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Heart Rate Variability Parameter ◽  
History Of ◽  
The Right ◽  
The Impact

Abstract Funding Acknowledgements Centre of Postgraduate Medical Education No. 501-1-10-14-19 Background. Cardioneuroablation (CNA) - ablation of ganglionated plexi (GP) to eliminate or reduce parasympathetic overactivity, has been recently proposed as a new therapeutic method in patients with vaso-vagal syncope (VVS) due to cardioinhibitory or mixed mechanism. Purpose. To assess the impact of CNA on the type of VV response during tilt testing (TT). Methods. The study group consisted of the first 20 patients (7 males, mean age 38 ± 9 – year – old) enrolled in the ongoing prospective Roman study (NCT 03903744). All patients had a history of ECG documented syncope due to asystole and confirmed asystolic form of VVS at baseline TT. CNA was performed using electroanatomical system Carto 3 and radiofrequency applications delivered in the right and left atrium at the right anterior GP and right inferior GP sites. The second TT was performed three months later. Resting heart rate (HR) and heart rate variability parameter (SDDN) were also assessed. Results. At baseline TT, nineteen patients had cardioinhibitory syncope (asystole ranging from 3 to 60 s)  (sinus node arrest – 17 patients, A-V block – 2 patients) and 1 had mixed form of VVS (asystole lasting 3 s preceded by hypotension). During three-month follow-up no syncopal episodes were noted. At the 3-month TT, 6 (30 %) patients had no syncope whereas the remaining 13 (65 %)  had syncope – twelve (60 %) due to vasodepressor mechanism and only one (5 %) due to asystole - as before CNA. One patient did not have TT because of pregnancy. Mean resting HR after CNA was significantly faster and SDNN significantly lower than before the procedure (82 ± 9 vs 69 ± 11 beats/min, p = 0.0004 and 74 ± 22 vs 143 ± 40 ms, p = 0.00003, respectively) and these changes were was similar in those who fainted during second TT and those who did not (82 ± 11 vs 81 ± 4 beats/min, p = NS and (75 ± 2 vs 77 ± 18 ms, p = NS, respectively). Conclusions. CNA profoundly affects the type of VV reaction causing normalization of the response to tilting or changing cardiodepression to vasodepression. These effects are also depicted by changes in HR and heart rate variability. Elimination of TT-induced reflex asystole may prevent clinical recurrences of syncope during short-term follow-up. These findings encourage to conduct further studies involving CNA since this method appears to be effective and obviates the need for pacemaker implantation in young people with reflex asystolic syncope.

Heart rate variability in inappropriate sinus tachycardia

1998 ◽  
Vol 82 (4) ◽  
pp. 531-534 ◽  
Author(s):  
Agustin Castellanos ◽  
Federico Moleiro ◽  
Simon Chakko ◽  
Helbert Acosta ◽  
Heikki Huikuri ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sinus Tachycardia ◽  
Inappropriate Sinus Tachycardia

scholarly journals Inappropriate Sinus Tachycardia Following Viral Illness

2021 ◽  
Vol 11 (2) ◽  
pp. 219-222
Author(s):  
Khalid Sawalha ◽  
Fuad Habash ◽  
Srikanth Vallurupalli ◽  
Hakan Paydak
Keyword(s):  
Viral Infection ◽  
Medical History ◽  
Sinus Tachycardia ◽  
Esophageal Disease ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Inappropriate Sinus Tachycardia ◽  
Laboratory Findings ◽  
Viral Illness ◽  
History Of

A 67-year-old female patient with a past medical history of menopause, migraines, and gastro-esophageal disease presented with palpitation, fatigue, and shortness of breath. One month prior to her presentation, she reported having flu-like symptoms. Her EKG showed sinus tachycardia with no other abnormality. Laboratory findings, along with imaging, showed normal results. The event monitor failed to detect any arrythmias. We report a case of inappropriate sinus tachycardia secondary to viral infection as a diagnosis of exclusion.

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