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Tytuł pozycji:

Efficacy of medical and ablation therapy for inappropriate sinus tachycardia: A single‐center experience.

Tytuł :
Efficacy of medical and ablation therapy for inappropriate sinus tachycardia: A single‐center experience.
Autorzy :
Shabtaie, Samuel A.
Witt, Chance M.
Asirvatham, Samuel J.
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Temat :
ACADEMIC medical centers
CATHETER ablation
HEALTH outcome assessment
RETROSPECTIVE studies
TERTIARY care
SINOATRIAL node
TREATMENT effectiveness
DISEASE relapse
ADRENERGIC beta blockers
TACHYCARDIA
DRUG prescribing
DESCRIPTIVE statistics
PHYSICIAN practice patterns
MEDICAL prescriptions
Źródło :
Journal of Cardiovascular Electrophysiology; Apr2021, Vol. 32 Issue 4, p1053-1061, 9p, 5 Charts
Czasopismo naukowe
Background: Effective therapy for inappropriate sinus tachycardia (IST) remains challenging with high rates of treatment failure and symptom recurrence. It is uncertain how effective pharmacotherapy and procedural therapy are long‐term, with poor response to medical therapy in general. Methods: We retrospectively reviewed all patients with the diagnosis of IST at a tertiary academic medical center from 1998 to 2018. We extracted data related to prescribing patterns and symptom response to medical therapy and sinus node modification (SNM), assessing efficacy and periprocedural complication rates. Results: A total of 305 patients with a formal diagnosis of IST were identified, with 259 (84.9%) receiving at least one prescription medication related to the condition. Beta‐blockers were the most commonly used medication (n = 245), with a majority of patients reporting no change or worsening of symptoms, and poor response was seen to other medication classes. Improvement was seen significantly more often with ivabradine than beta blockers, though the sample size was limited (p =.003). Fifty‐five patients (18.0% of all IST patients), mean age 32.0 ± 9.1 years, underwent a SNM procedure, with an average of 1.8 ± 0.9 procedures per patient. Acute symptomatic improvement (<6 months) was seen in 58.2% of patients. Long‐term complete resolution of symptoms was seen in 5.5% of patients, modest improvement in 29.1%, and no long‐term benefit was seen in 65.5% of patients. Conclusions: Among all medical therapies, there were high rates of treatment failure or symptom worsening in over three‐quarters of patients in our study. Ivabradine was most beneficial, though the sample size was small. While most patients receiving SNM ablation for IST perceive an acute symptomatic improvement, almost two‐thirds of patients have no long‐term improvement, and resolution of symptoms is quite rare. AV node ablation with pacemaker implantation following lack of response to SNM offered increased success, though the sample size was limited. [ABSTRACT FROM AUTHOR]
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