scholarly journals Atrial Tachycardia Masquerading As Inappropriate Sinus Tachycardia (IST) After COVID-19 Infection: A Matter of Concern?

Cureus ◽  
2021 ◽  
Author(s):  
Anamika Giri ◽  
Dhruv Talwar ◽  
Sourya Acharya ◽  
Daljeet K Saggu ◽  
Sunil Kumar
Keyword(s):  
Atrial Tachycardia ◽  
Sinus Tachycardia ◽  
Inappropriate Sinus Tachycardia

scholarly journals Persistent Atrial Tachycardia Mimicking Inappropriate Sinus Tachycardia: A Case Report

2011 ◽  
Vol 27 (3) ◽  
pp. 214-219
Author(s):  
Toshihiko Kubo ◽  
Masaru Takahashi ◽  
Koji Sakai ◽  
Hidenori Matsusaka ◽  
Junichiro Koga ◽  
...  
Keyword(s):  
Case Report ◽  
Atrial Tachycardia ◽  
Sinus Tachycardia ◽  
Inappropriate Sinus Tachycardia

Abstract 15694: Atrial Tachycardia Masquerading as Sinus Tachycardia - Electrophysiological Characteristics and Ablation Outcomes

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Rakesh Gopinathannair ◽  
Krishna Akella ◽  
Ghulam Murtaza ◽  
Luigi Di Biase ◽  
Andrea Natale ◽  
...  
Keyword(s):  
Atrial Tachycardia ◽  
Sinus Tachycardia ◽  
Sinus Node ◽  
Outcome Data ◽  
P Wave ◽  
Autonomic Response ◽  
Inappropriate Sinus Tachycardia ◽  
P Waves ◽  
Wave Morphology ◽  
Activation Mapping

Background: Focal atrial tachycardia (AT) is typically distinguished by P wave morphology and autonomic response. AT arising close to the sinus node can be easily misdiagnosed as Inappropriate sinus tachycardia (IST). Objective: This multicenter study sought to describe the electrophysiological (EP) features and ablation outcomes of perisinus node atrial tachycardia (PNAT). Methods: Baseline as well as procedural characteristics and outcome data of 7 patients with PNAT are described. Results: Mean age of the cohort was 38±17 years (100% female). Time from symptom onset to diagnosis was12.2± 9 months with an average of 1.7 prior hospitalizations. Mean baseline HR was127.8 bpm and all patients carried a diagnosis of IST. Baseline ECG in all patients was identical to sinus tachycardia, with exception of taller P waves in lead II in 5 patients and deeper negative component of P wave in V1. At EP study, mean AT cycle length was 420 msec and significant acceleration was seen with isoproterenol, mimicking IST. Activation mapping was done using Ensite TM Balloon Array (5), Precision TM (1) and Carto TM (1). Site of origin was slightly anterolateral to sinus node in 3 and anterior, inferior and medial to sinus node in 4 (Figure). AT was successfully ablated in all patients without any phrenic injury or sinus node dysfunction. Over 2.9 years of follow-up, only 1 patient had recurrence that was successfully re-ablated. Conclusion: PNAT has similar ECG and EP characteristics and is often misdiagnosed as IST. A high index of suspicion is needed for diagnosis. Evaluation of P wave morphology during tachycardia and careful activation mapping can enable successful ablation with excellent long-term outcomes.

scholarly journals Pregnancy related inappropriate sinus tachycardia: a distinct arrhythmia?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Sharp ◽  
C Patient ◽  
J Pickett ◽  
M Belham
Keyword(s):  
Sinus Tachycardia ◽  
Task Force ◽  
Cohort Analysis ◽  
Subsequent Pregnancy ◽  
Autonomic Response ◽  
Inappropriate Sinus Tachycardia ◽  
Background Rate ◽  
Persistent Symptoms ◽  
Coronary Syndrome ◽  
In Pregnancy

Abstract Background The syndrome of inappropriate sinus tachycardia (IST) is well recognized and affects ∼1% of the population. We believe IST in pregnancy is a relatively frequent yet under-recognized phenomenon that may represent a distinct arrhythmia. To date, there are only three case reports in the literature. Purpose To further understand the natural history of IST in pregnancy, and to explore maternal outcomes. Methods A retrospective, observational cohort analysis. Results 19 pregnant women presented to our institute with a definitive diagnosis of IST (as defined by task force criteria) between January 2016 and January 2017. Symptom onset was 4–36 weeks gestation (mean 20 weeks). Of those in their second or subsequent pregnancy (n=8), 50% described symptoms compatible with IST in previous pregnancies. 42% attended the emergency department on ≥1 occasion with symptoms of IST. 32% required hospital admission. 26% required pharmacological therapy (beta-blockers in all). There were no maternal deaths, instances of heart failure or acute coronary syndrome, no thromboembolic or haemorrhagic complications during pregnancy. Rates of Caesarean section were similar to the background rate of our unit; however, rates of induction were notably elevated (58% vs 25%), with 55% of these women being induced purely for symptoms of IST. Following delivery, symptoms resolved within one week for 17 of the women in the cohort, 1 had symptoms resolve after 4 month and 1 had persistent symptoms as she became pregnant again. Conclusion IST in pregnancy likely represents a distinct arrhythmia; the majority of individuals here had symptoms only during pregnancy, which resolved rapidly postpartum. Additionally, half of the women in a second or subsequent pregnancy had suffered IST symptoms during previous pregnancies, with no symptoms in between pregnancies. It is biologically plausible and may represent an exaggerated cardio-autonomic response to the physiological changes of pregnancy such as increased sympathetic tone and change in baroreceptor reflex sensitivity. Recognition of the condition is important given it is associated with significant morbidity, the distressing nature of symptoms leading to high rates of hospitalization and induction of labour. Funding Acknowledgement Type of funding source: None

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