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I would to talk with someone that has had the procedure for Inappropriate Sinus Tachycardia

By Anonymous January 25, 2012 - 2:02pm
 
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I am a 57 yr. old female with Diabetes, High Blood Pressure and I am 2 yrs cancer free from kidney cancer. My dr. says I now have Inappropraite Sinus Tachycardia (IST) because my heartrate is up to 150. I was on a 30 heart monitor and I had a stress test done.The results of the monitor showed I have IST. My stress test came out normal. He says I need a procedure to close an extra pathway leading from my heart. Its an outpatient procedure. They go up the groin to the pathway and burn it closed. The bad thing is that if they tap the main point, I may have to have a pacemaker inserted. Is it worth the risk? Can I have a heart attack if I leave it alone? Will this IST get worse if left untreated?

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Maryann Gromisch RN
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These are all serious questions which you should be asking your cardiologist.

I can understand that you may want to converse with other people who may have inappropriate sinus tachycardia (IST) and have undergone this proposed treatment.

I can only provide you with information that I have found. According to the Mayo Clinic,

"Inappropriate sinus tachycardia doesn't cause heart damage, though patients may feel uncomfortable with the elevated heart rate. Some patients may have other associated symptoms such as fatigue, headache, chest discomfort, shortness of breath or light-headedness. When symptoms are problematic, treatment can include beta blockers that block the action of adrenaline and help slow the heart rate. Very rarely, the heart may maintain very high rates of 160 to 180 beats per minute. More involved treatment options are available to control this condition.

For some patients, the elevated heart rate is the only symptom. Some have a lifelong history of sinus tachycardia in the 110 beats per minute range, and they lead a normal, healthy life. And often the inappropriate sinus tachycardia will improve in time without treatment." Stephen Hammill, M.D., Cardiology, Mayo Clinic, Rochester, Minn.

According to the website, Heartracing.com:

"The prognosis of patients with IST is excellent: it does not shorten life or cause death, stroke or myocardial infarction. It virtually never leads to tachycardiomyopathy – so if it occurs, the likelihood is that the tachycardia is arising from an atrial focus, not the sinus node. However, IST usually continues to bother the patient until something is done. Many patients initially take a wait and see approach to their IST. However as months and years pass, nearly every patient experiences more symptoms which then begin to interfere with work and other activities necessary for normal quality of life in these young patients. These patients almost always seek help for this condition.

Because IST does not shorten life, the treatment of it does not prevent a catastrophe and prolong life. The only reason therefore to treat IST then is to alleviate symptoms. Patients with IST have four general options for therapy: doing nothing to prevent or cure IST, taking medications, having an ablation procedure or having open-heart surgery. Practically, patients needing open-heart surgery for another reason or those with sever symptoms who have failed all other therapies may have a surgical approach to their IST, but this is quite rare. For the remainder it is living with IST, taking heart rhythm medications, or having an ablation for cure.

Ablation is the option selected by the majority of patients with IST. In some fortunate patients, there is an irritable spot close to the sinus node that can be ablated without risk to the normal sinus node (5). For most patients, however, the tachycardia is arising from the sinus node itself. In most people, the tachycardia responsible for the IST arises from the part of the sinus node located more cranial, anterior and medial. In these patients, this part of the sinus node which is responsible for the faster sinus tachycardias is ablated, without affecting the part of the sinus node responsible for normal sinus rhythm. These patients usually have the very fast tachycardias improved or eliminated without damage to the main part of the sinus node. In other patients, the origin of the sinus tachycardia arises from the main part of the sinus node. These patients are at risk for destruction/damage of the main sinus node producing sick sinus syndrome requiring a pacemaker if aggressive ablation is performed. However, if too definitive ablation does not occur, then the tachycardia will recur. Therefore it is important that the patient and the electrophysiologist communicate accurately and thoroughly before the procedure about the risk of either a pacemaker or on the other hand the chance of requiring a second ablation procedure. This will allow the electrophysiologist to tailor the procedure to the wishes of the patient." 

You can read more about the procedure at http://heartracing.com/physicians/inappropriate.sinus.tachycardia.asp

I hope that I have given you some information to help you make your decision. Wishing you the very best.

Maryann

 

January 25, 2012 - 5:10pm

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