Taquicardia sinusal y taquicardia sinusal inapropiada

  1. Lozano Granero, C.
  2. Valverde Gómez, M.
  3. Rodríguez Muñoz, D.
  4. Zamorano Gómez, J.L.
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2017

Título del ejemplar: Enfermedades cardiológicas (V) Arritmias (II)

Serie: 12

Número: 39

Páginas: 2309-2313

Tipo: Artículo

DOI: 10.1016/J.MED.2017.07.011 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Objetivos de desarrollo sostenible

Resumen

Abstract/Introduction Sinus tachycardia is one of the most frequently encountered arrhythmias in clinical practice and its identification should place us on the trail of an intercurrent process in our patient, which may be benign (anxiety or painful) or life threatening (sepsis Severe or pulmonary thromboembolism, among others). On the other hand, inappropriate sinus tachycardia does not respond to a normal pathophysiological mechanism. Diagnosis The diagnosis will be based on a correct differential electrocardiographic diagnosis to differentiate it from other arrhythmias, fundamentally the atrial tachycardia and in a complete study that allows us to identify the cause that causes it, or to rule out its existence. A 24-hour holter-ECG may be useful in the diagnosis of inappropriate sinus tachycardia. Management In the case of appropriate sinus tachycardia, the treatment will correspond to the underlying pathology that has triggered the arrhythmia. For the inappropriate sinus tachycardia, the braking agents, particularly ivabradine, are useful because of their selective effect on the sinus node and its excellent hemodynamic profile, which makes them very safe and well tolerated drugs.

Referencias bibliográficas

  • Feld G. Inappropriate sinus tachycardia. En: Al-Ahmad A. Electroanatomical Mapp an atlas for clinicians. New Jersey: Wiley Blackwell. 2009.p.51-3.
  • Nwazue VC, Paranjape SY, Black BK, Biaggioni I, Diedrich A, Dupont WD. Postural tachycardia syndrome and inappropriate sinus tachy-cardia: role of autonomic modulation and sinus node automaticity. J Am Heart Assoc. 2014;3(2):e000700.
  • Still A, Huikuri HV, Airaksinen KEJ, Koistinen MJ, Kettunen R, Hartikainen J. Impaired negative chronotropic response to adenosine in patients with inappropriate sinus tachycardia. J Cardiovasc Electrophysiol. 2002;13(6):557-62.
  • Chiale PA, Garro HA, Schmidberg J, Sánchez RA, Acunzo RS, Lago M. Inappropriate sinus tachycardia may be related to an immunologic disorder involving cardiac beta andrenergic receptors. Hear Rhythm. 2006;3(10):1182-6.
  • Morillo C, Guzmán JC. Taquicardia sinusal inapropiada: actualización. Rev Española Cardiol. 2007;60(Supl 3):10-4.
  • Brady PA, Low PA, Shen WK. Inappropriate sinus tachycardia, postural orthostatic tachycardia syndrome, and overlapping syndromes. PACE - Pacing Clin Electrophysiol. 2005;28(10):1112-21.
  • Jacob G, Biaggioni I. Idiopathic orthostatic intolerance and postural ta-chycardia syndromes. Am J Med Sci. 1999;317(2):88-101.
  • Thieben MJ, Sandroni P, Sletten DM, Benrud-Larson LM, Fealey RD, Vernino S. Postural orthostatic tachycardia syndrome: the Mayo clinic experience. Mayo Clin Proc. 2007;82(3):308-13.
  • Kimpinski K, Figueroa JJ, Singer W, Sletten DM, Iodice V, Sandroni P. A prospective, 1 year followup study of postural tachycardia syndrome. Mayo Clin Proc. 2012;87(8):746-52.
  • Schondorf R, Low PA. Idiopathic postural orthostatic tachycardia syndrome: an attenuated form of acute pandysautonomia? Neurology. 1993; 43(1):132-7.
  • Vernino S, Low PA, Fealey RD, Stewart JD, Farrugia G, Lennon VA. Autoantibodies to ganglionic acetylcholine receptors in autoimmune au-tonomic neuropathies. N Engl J Med. 2000;343(12):847-55.
  • Raj SR, Biaggioni I, Yamhure PC, Black BK, Paranjape SY, Byrne DW. Renin-aldosterone paradox and perturbed blood volume regulation underlying postural tachycardia syndrome. Circulation. 2005;111(13): 1574-82.
  • Garland EM, Raj SR, Black BK, Harris PA, Robertson D. The hemodynamic and neurohumoral phenotype of postural tachycardia syndrome. Neurology. 2007;69(8):790-8.
  • Stewart JM, Medow MS, Montgomery LD. Local vascular responses affecting blood flow in postural tachycardia syndrome. Am J Physiol Heart Circ Physiol. 2003;285(6):H2749-56.
  • Sandroni P, Opfer-Gehrking TL, McPhee BR, Low PA. Postural tachycardia syndrome: clinical features and follow-up study. Mayo Clin Proc. 1999;74(11):1106-10.
Fuente de los datos: Dialnet