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Ablation of inappropriate sinus tachycardia: Is it time to review choices?

      The sinus node is a highly complex biosensor whose function is controlled by extrinsic and intrinsic variables consisting of blood gases and pH, hormonal and nonhormonal chemicals, temperature, stretch, autonomic nervous system, midbrain, and cerebral cortex drive. It is strictly controlled by more than 15 ionic electrical currents. The complexity of these functions explains the difficulty in understanding the physiology, pathology, and treatment of conditions such as inappropriate sinus tachycardia (IST). The Heart Rhythm Society 2015 Expert Consensus Statement defined IST as a sinus heart rate (HR) >100 bpm at rest (mean 24-hour HR >90 bpm not due to primary causes) associated with distressing symptoms of palpitations. Despite IST being a benign condition, sometimes it can be highly symptomatic and debilitating.
      • Sheldon R.S.
      • Grubb B.P.
      • Olshansky B.
      • et al.
      2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope.
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      References

        • Sheldon R.S.
        • Grubb B.P.
        • Olshansky B.
        • et al.
        2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope.
        Heart Rhythm. 2015; 12: e41-e63
        • Olshansky B.
        • Sullivan R.M.
        Inappropriate sinus tachycardia.
        Europace. 2019; 21: 194-207
        • Rodríguez-Mañero M.
        • Kreidieh B.
        • Al Rifai M.
        • et al.
        Ablation of inappropriate sinus tachycardia: a systematic review of the literature.
        JACC Clin Electrophysiol. 2017; 3: 253-265
        • Page R.L.
        • Joglar J.A.
        • Caldwell M.A.
        • et al.
        2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
        Heart Rhythm. 2016; 13: e136-e221
        • Katritsis D.G.
        • Boriani G.
        • Cosio F.G.
        • et al.
        European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardiaca y Elect.
        Eur Heart J. 2018; 39: 1442-1445
        • Lakkireddy D.
        • Garg J.
        • DeAsmundis C.
        • et al.
        Sinus node sparing hybrid thoracoscopic ablation outcomes in patients with inappropriate sinus tachycardia (SUSRUTA-IST Registry).
        Heart Rhythm. 2022; 19: 30-38
        • de Asmundis C.
        • Chierchia G.B.
        • Sieira J.
        • et al.
        Sinus node sparing novel hybrid approach for treatment of inappropriate sinus tachycardia/postural orthostatic sinus tachycardia with new electrophysiological finding.
        Am J Cardiol. 2019; 124: 224-232
        • Zhao Y.
        • Jiang Z.
        • Tsai W.-C.
        • et al.
        Ganglionated plexi and ligament of Marshall ablation reduces atrial vulnerability and causes stellate ganglion remodeling in ambulatory dogs.
        Heart Rhythm. 2016; 13: 2083-2090
        • Pachon M.J.C.
        • Pachon M.E.I.
        • Santillana P.T.G.
        • et al.
        Simplified method for vagal effect evaluation in cardiac ablation and electrophysiological procedures.
        JACC Clin Electrophysiol. 2015; 1: 451-460

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