Kansas City Heart Rhythm Institute, Overland Park, Kansas, USA.
Loma Linda University Hospital, Heart Arrythmia and Electrophysiology, Loma Linda, California, USA.
J Am Coll Cardiol. 2022 Jun 21;79(24):2450-2462. doi: 10.1016/j.jacc.2022.04.019.
Inappropriate sinus tachycardia (IST) is a clinical syndrome that generally affects young patients and is associated with distressing symptoms. Although the most common symptom is palpitations, it can be accompanied by a myriad of symptoms, including anxiety, dizziness, presyncope, and syncope. The pathogenesis of IST is not well understood and considered multifactorial, with autonomic dysfunction being the central abnormality. IST is a diagnosis of exclusion. Management presents a clinical challenge. The overall efficacy of lifestyle modifications and medical therapy may be limited. Recent advances in catheter and surgical sinus node sparing ablation techniques have led to improvement in outcomes. In addition, increased focus has led to development of multimodality team-based interventions to improve outcomes in this group of patients. In this review, we discuss the mechanistic basis of IST, review current approaches to diagnosis, and outline contemporary therapeutic approaches.
不适当窦性心动过速（IST）是一种常见于年轻患者的临床综合征，与令人痛苦的症状有关。虽然最常见的症状是心悸，但它可能伴有许多症状，包括焦虑、头晕、晕厥前和晕厥。IST 的发病机制尚不清楚，被认为是多因素的，自主神经功能障碍是中心异常。IST 是一种排除性诊断。管理提出了临床挑战。生活方式改变和药物治疗的整体疗效可能有限。导管和窦房结保留消融技术的最新进展导致了结果的改善。此外，人们越来越关注多模式团队干预，以改善这群患者的结局。在这篇综述中，我们讨论了 IST 的机制基础，回顾了目前的诊断方法，并概述了当代治疗方法。
