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“Inappropriate Sinus Tachycardia” with Symptoms
Good Evening,
I was diagnosed with “inappropriate sinus tachycardia” by my EP in June 2023 and have been dealing with worsening symptomatic DOE and tachycardia (consistently 120 bpm, up to 150 bpm) that occurs with minimal exertion, then returns to “normal resting heart rate” with upon sitting and/or < 1 minute of standing still. No changes in HR with sit-to-stand and no orthostatic symptoms, only with minimal exertion (walking). To date, I have failed multiple AV nodal agents due to drug intolerance (which actually create new POTS symptoms).
Currently, ivabradine isn’t an option because of insurance and economic barriers.
Based on a literature study (I happen to be a PhD candidate in cardiac engineering and electrophysiology) I have ‘class II’, non-typical IST, defined as “normal resting heart rate (< 85 bpm) with an exaggerated increase in HR in response to minimal exertion”.
All secondary causes (including environmental and dietary) for my tachycardia and symptoms have been ruled out.
Has anyone else had a similar IST experience?
Thanks in advance for any insight, suggestions, and/or feedback.
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I had low(40)and walking (120)and my cardio wanted to give me a pacemaker for lows and more meds for highs.
My PCP titrated my meds over a couple of months and got me back on track. It even helped my arrhythmia.
Hello @beberl, I'd like to invite @rivermaya34 and @rinadbq who have also talked about their experiences with inappropriate sinus tachycardia to share any insight they have learned on their journey.
I have same symptoms and signs. Long history of sinus tach but stress or exercise as cause in past. But prodromal since 2nd week of January, sought care in March. Bad choices with choosing my care team and mistakes by them and I had to switch care networks. They said I was fine but they found pSVT on my 14 day holter monitor which was no big deal. But, my Ins Co's Cardiology specialist who reviewed my case and went over the tracings throughout the 14 days found Ventricular Tachycardia that the algorithm (which the FDA reported last year as having issues with it missing incidences of Ventricular Tachycardia) that my former cardiologist missed because he never looked at the actual tracings...he just went by the AI interpretative algorithm determination which missed it altogether. V-Tach is very very dangerous....SVT not alot safer but less likely to be deadly. You may be having just IST or you could be having different types of Tachycardia too. New arrhythmias can surface at any time so don't assume it is necessarily only some miserable but usually harmless IST. Things in our bodies can change rapidly and many people with one type of arrhythmia have others at one time or another....all just electrical currents that can get screwy....especially as we get older. There are at least several different types of Tachycardia....don't assume this is all the IST.
First thing tomorrow am call your care team and let them know what is going on and ask for a holter monitor at for at least 14 days....and make sure to request that a live person in your care network go over the tracings to cross-check the accuracy of the AI algorithm so they don't miss something. Better to play it safe and be wrong than to make assumptions that this is just a form of S-Tach and end up in ICU or worse. Play it smart and make the call. It is kinda a life or death thing when your heart's electricity is setting off flares. Call....your life is worth saving too.