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Europace 2005 7(2):104-112; doi:10.1016/j.eupc.2004.12.007
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Prevalence, characteristics and natural course of inappropriate sinus tachycardia

Aino-Maija Stilla,*, Pekka Raatikainena, Antti Ylitalob, Heikki Kaumac, Markku Ikäheimoa, Y. Antero Kesäniemic and Heikki V. Huikuria

aDepartment of Internal Medicine, Division of Cardiology, University of Oulu P.O. Box 5000, FIN-900014, Finland; bSatakunta Central Hospital Pori, Finland; cDepartment of Internal Medicine and Biocenter Oulu, University of Oulu Oulu, Finland

AIMS: To study the prevalence, characteristics and natural course of inappropriate sinus tachycardia (IST).

METHODS AND RESULTS: The prevalence and characteristics of IST were evaluated in a random sample of 604 middle-aged subjects. Seven of the subjects (1.16%) fulfilled the contemporary diagnostic criteria of IST. The systolic (147 ± 11 mmHg vs. 130 ± 13 mmHg, P < 0.001) and diastolic ambulatory blood pressures (92 ± 7 mmHg vs. 81 ± 8 mmHg, P < 0.001) were higher among the subjects with IST than among the controls. The other laboratory, echocardiographic and personality measurements, with the exception of the hostility score (10 ± 2 vs. 8 ± 3, P < 0.001), revealed no differences between the groups. The natural course and prognosis of the disorder was assessed among the subjects fulfilling the IST criteria and nine previously diagnosed IST patients. During a mean follow-up of 6.0 ± 2.4 years, none of the subjects developed any clinical or echocardiographic evidence of structural heart disease despite ongoing palpitations, and there was no significant reduction in the 24-h average HR (94 ± 2 bpm vs. 89 ± 8 bpm, P = 0.204).

CONCLUSION: The prevalence of IST in a middle-aged population was higher than previously assumed. Despite the chronic nature of the disorder, the prognosis of IST was benign. The causal relationship between IST and hypertension and/or hostile personality type remains speculative.

Key Words: inappropriate sinus tachycardia, prevalence, characteristics, natural course, prognosis

*Corresponding author. Tel.: +358 8 315 2011; fax: +358 8 315 4139. E-mail address: aino-maija.still{at}fimnet.fi (A.-M. Still).


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