Inappropriate sinus tachycardia

Inappropriate sinus tachycardia is a sinus tachycardia that has no identifiable underlying causeBrugada 2020. Specific drug treatment is not usually required; however, for patients with intolerable symptoms, one of the following drugs may provide reliefLopez-Sendon 2004:

1atenolol 25 mg orally, daily, increasing if required up to 100 mg daily atenolol atenolol atenolol

OR

1metoprolol tartrate 25 mg orally, twice daily, increasing if required up to 100 mg twice daily metoprolol metoprolol metoprolol

OR

1verapamil modified-release 180 mg orally, daily, increasing if required up to 480 mg daily. verapamil verapamil verapamil

For patients with severe symptoms due to inappropriate sinus tachycardia, ivabradine is sometimes used as monotherapy or in combination with a beta blocker under specialist supervisionBrugada 2020Ptaszynski 20131.

If severe symptoms are caused by emotional stress or anxiety, consider treatment of the psychological condition. If severe symptoms persist despite drug therapy or treatment of the psychological condition, refer for electrophysiology study to exclude other atrial arrhythmiasBrugada 2020.

1 At the time of writing, ivabradine is not approved by the Australian Therapeutic Goods Administration (TGA) for use in inappropriate sinus tachycardia. See the TGA website for current information.Return