Inappropriate sinus tachycardia medical therapy

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

Treatments in the form of pharmacological therapy or catheter ablation are available, although it is currently difficult to treat successfully.

In so far as the pathophysiology of IST involves abnormal sensitivity to adrenaline, betaa-blockers can be helpful.

Although calcium channel blockers slow conduction through the AV node, they have been marginally effective in the treatment of IST.

A new selective sinus node inhibitor Ivabradine is also being used to treat IST.

In so far as the underlying pathophysiology may involve a dysautonomia and features of Postural orthostatic tachycardia syndrome (POTS), some therapies more commonly used to treat these disorders have been tried:

• Fludrocortisone (Florinef)

POTS and dysautonomia have been associated with decreases in blood volume, and this drug promotes sodium retention.

• Midodrine

Midodrine increases vasoconstriction, and prevents falls in blood pressure.

• Serotonin-reuptake inhibitors (SSRIs)

SSRIs have proven effective in treating some patients with dysautonomia.

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