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Inappropriate Sinus Tachycardia

Hello!

I was just diagnosed with IST after a long, laborious year of tests and a lot of useless medicine. I am 24 years old and have had signs of IST for as far back as I can remember. I get dizzy, have a racing heartbeat, have near blackouts and have a severe intolerance to exercise (have had episodes of black-outs and near passing out on the tennis court and a feeling as if my heart will explode). Am always short of breath and also have difficulty with standing, getting out of bed, etc. etc. My heart rate frequents 160bpm and higher.

Initially, the dr's thought I had anxiety probs, so I was put on Xanax and then Paxil. After further testing, they realized from the results of my holter test that I wasn't crying wolf, so they put me on Atenolol, which didn't work. I went from Atenolol to Cardizem CD, from the Cardizem to Verapamil, and am now beginning to take 50mg of Toprol as prescribed by my new cardiologist.

I was wondering how effective Toprol is in relieving the symptoms of IST and whether or not it leaves you fatigued like the Atenolol does. I've only been on it for two days. Also, is this medicine something I am going to have to take for the rest of my life? What is its effect on pregnancies? How serious is a diagnosis of IST? Should I be sent for a tilt table test? I've noticed the similarity between POTS and IST. Have been looking for someone to compare notes with on this. I'd like to hear your thoughts. I have noticed a huge negative effect on my quality of life, so I am anxious to get on the road to better health!

Thank you for your help!
Heather (***@****)
1 Responses
238668 tn?1232735930
MEDICAL PROFESSIONAL
Q:I was wondering how effective Toprol is in relieving the symptoms of IST and whether or not it leaves you fatigued like the Atenolol does. I've only been on it for two days. Also, is this medicine something I am going to have to take for the rest of my life?
A: Toprol is similar to atenolol and may also cause fatigue.  There are some modifications of the sinus node that can be done to treat IST and avoid medication.

Q: What is its effect on pregnancies? How serious is a diagnosis of IST?
A: No effect on pregnancy and more of a nusiance than a serious condition.

Q:Should I be sent for a tilt table test? I've noticed the similarity between POTS and IST.
A: There are similarities between the two and a tilt table does help sort out the differences.  The treatment however is similar.

Below are some journal articles that address this topic in depth.  Your local medical library should be able to help you find copies.

Review Articles:

Krahn AD.  Yee R.  Klein GJ.  Morillo C.  Inappropriate sinus tachycardia: evaluation and therapy. Journal of Cardiovascular Electrophysiology.  6(12):1124-8, 1995 Dec.


Sims JM.  Miracle V.  Sinus tachycardia. Nursing.  26(6):49, 1996 Jun.


Articles Concerning Catheter Treatment Options.

Lee RJ.  Kalman JM.  Fitzpatrick AP.  Epstein LM.  Fisher WG.  Olgin JE.  Lesh MD.  Scheinman MM. Radiofrequency catheter modification of the sinus node for "inappropriate" sinus tachycardia. Circulation.  92(10):2919-28, 1995 Nov 15.


Jayaprakash S.  Sparks PB.  Vohra J.  Inappropriate sinus tachycardia (IST): management by radiofrequency modification of sinus node.  Australian & New Zealand Journal of Medicine.  27(4):391-7, 1997 Aug.


Surgical treatment  (Only as a last resort)
Esmailzadeh B.  Bernat R.  Winkler K.  Meybehm M.  Pfeiffer D.  Kirchhoff PG.  Surgical excision of the sinus node in a patient with inappropriate sinus tachycardia.  Journal of Thoracic & Cardiovascular Surgery.  114(5):861-4, 1997 Nov.
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