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Natural history and clinical outcomes of inappropriate sinus tachycardia
Author(s) -
Shabtaie Samuel A.,
Witt Chance M.,
Asirvatham Samuel J.
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14288
Subject(s) - medicine , ejection fraction , myocardial infarction , depression (economics) , anxiety , cardiology , natural history , tachycardia , cohort , sinus tachycardia , pediatrics , heart failure , psychiatry , economics , macroeconomics
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.