Inappropriate sinus tachycardia: focus on ivabradine

Intern Med J. 2016 Aug;46(8):875-83. doi: 10.1111/imj.13093.

Abstract

Inappropriate sinus tachycardia (IST) is an incompletely understood condition, characterised by an elevation in heart rate (HR) accompanied by wide ranging symptoms in the absence of an underlying physiological stimulus. The condition often takes a chronic course with significant adverse effects on quality of life. Currently, there is no effective treatment for IST. Beta-blockers, generally considered the cornerstone of treatment, are often ineffective and poorly tolerated. Ivabradine is a novel sinus node If 'funny current' inhibitor, which reduces the HR. It has been approved for the treatment of beta-blocker refractory chronic systolic heart failure and chronic stable angina but more recently has shown promise in the treatment of IST. This review provides an overview of IST prevalence and mechanisms followed by an examination of the evidence for the role and efficacy of ivabradine in the treatment of IST.

Keywords: inappropriate sinus tachycardia; ivabradine.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Benzazepines / adverse effects
  • Benzazepines / therapeutic use*
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Diagnosis, Differential
  • Disease Management
  • Electrocardiography, Ambulatory
  • Heart Rate / drug effects
  • Humans
  • Ivabradine
  • Practice Guidelines as Topic
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Tachycardia, Sinus / diagnosis*
  • Tachycardia, Sinus / drug therapy*
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Benzazepines
  • Cardiovascular Agents
  • Ivabradine