Inappropriate sinus tachycardia diagnostic criteria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

No formal diagnostic criteria exist. A diagnosis of Inappropriate sinus tachycardia is primarily a diagnosis of exclusion and the following must be observed:

• Exclusion of all other causes of sinus tachycardia
• Common forms of supraventricular tachycardia (SVT) must be excluded
• Normal P wave morphology
• A resting sinus tachycardia is usually (but not always) present
• A nocturnal reduction in heart rate from over 100 beats per minute to 80 – 90 beats per minute
• There is an inappropriate heart rate response on exertion so that the heart rate accelerates to 140 – 150 beats per minute with minimal exertion.
• The mean heart rate during 24 hrs of monitoring is > 95 bpm
• Symptoms are documented to be due to tachycardia
• Hypotension may occasionally be observed
• Syncope (fainting) is occasionally reported

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