Prevalence, characteristics and natural course of inappropriate sinus tachycardia
Open accessAbstract
AIMS: To study the prevalence, characteristics and natural course of inappropriate sinus tachycardia (IST). METHODS AND RESULTS: The prevalence and characteristics of IST were evaluated in a random sample of 604 middle-aged subjects. Seven of the subjects (1.16%) fulfilled the contemporary diagnostic criteria of IST. The systolic (147+/-11 mmHg vs. 130+/-13 mmHg, P<0.001) and diastolic ambulatory blood pressures (92+/-7 mmHg vs. 81+/-8 mmHg, P<0.001) were higher among the subjects with IST than among the controls. The other laboratory, echocardiographic and personality measurements, with the exception of the hostility score (10+/-2 vs. 8+/-3, P<0.001), revealed no differences between the groups. The natural course and prognosis of the disorder was assessed among the subjects fulfilling the IST criteria and nine previously diagnosed IST patients. During a mean follow-up of 6.0+/-2.4 years, none of the subjects developed any clinical or echocardiographic evidence of structural heart disease despite ongoing palpitations, and there was no significant reduction in the 24-h average HR (9+/-2 bpm vs. 89+/-8 bpm, P=0.204). CONCLUSION: The prevalence of IST in a middle-aged population was higher than previously assumed. Despite the chronic nature of the disorder, the prognosis of IST was benign. The causal relationship between IST and hypertension and/or hostile personality type remains speculative.
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In the OPERA trial, 1.16% (seven individuals, four female) of 604 middle-aged subjects had heart rates consistent with the trial's definition of IST but were not necessarily symptomatic.
“Thus, 1.16%, seven individuals, of whom, four were female, had heart rates consistent with the trial's definition of IST 22 but these individuals were not necessarily symptomatic.”
From Inappropriate sinus tachycardia (2019) · cites this paper as [22]
Inappropriate sinus tachycardia tends to be persistent, and most affected patients are young and female, though not limited to that population.
“The tachycardia tends to be persistent and most of the affected patients are young and female, but this disorder is not limited to that population.95”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [95]
The prognosis of inappropriate sinus tachycardia is generally considered benign despite limited long-term data.
“Despite limited information about the long-term consequences of inappropriate sinus tachycardia the prognosis is generally considered benign, 95”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [95]
24-h Holter monitoring in IST characteristically shows a mean heart rate above 90 bpm with an exaggerated heart rate response above 100 bpm during waking hours.
“The 24-h Holter monitoring characteristically demonstrates a mean HR .90bpm with an exaggerated HR response .100bpm during the waking hours.95”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [95]
Contemporary studies of mixed gender confirm a bell-shaped pattern of heart rate distribution while also showing a clear inflection point of the distribution skew at 85-90 bpm.
“Contemporary studies of mixed gender confirm this bell-shaped pattern while also showing a clear inflection point of the distribution skew at 85–90 bpm.11”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [11]
The only estimate of IST prevalence to date is the OPERA study that identified an IST prevalence of 1.16%, though this group included symptomatic and asymptomatic patients; in that study, 57% of IST patients were female with a mean age of 47.
“The only estimate of prevalence to date is the OPERA (Oulu Project Elucidating Risk of Atherosclerosis) study that identified an IST prevalence of 1.16%, though this group included symptomatic and asymptomatic patients. In that study, 57% of IST patients were female with a mean age of 47.11”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [11]
The percentage of heart rates above 90-100 bpm in population studies ranges from 2.1 to 4.6%.
“The percentage of heart rates above 90–100 bpm in population studies ranges from 2.1 to 4.6%.11,13–15”
From Sinus Tachycardia: a Multidisciplinary Expert Focused Review (2022) · cites this paper as [11]
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- Authors
- STILL, A., RAATIKAINEN, P., YLITALO, A., KAUMA, H., IKAHEIMO, M., ANTEROKESANIEMI, Y., & HUIKURI, H.
- Affiliations
- University of Oulu (FI)
- Satakunta Central Hospital (FI)
- Corresponding author
- STILL, A
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-03
- Volume
- 7
- Issue
- 2
- Pages
- 104-112
- ISSN
- 1099-5129 (ISSN-L)
- OpenAlex
- W2154667383
- Semantic Scholar
- b68857c50bcc121d87d3473ef3566dfd230af5e3
- Cited by
- 134
- References
- 38
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 10 · 2021: 10 · 2020: 7 · 2019: 10 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 11 · 2014: 5 · 2013: 12 · 2012: 9
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- Foundation for Cardiovascular Research
- Academy of Finland
- Sydäntutkimussäätiö
- Oulun Yliopisto
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- inappropriate sinus tachycardia, prevalence, natural course, prognosis, hypertension, hostility, palpitations, middle-aged adults, heart rate, structural heart disease
- MeSH terms
- Female, Finland, Heart Rate, Humans, Male, Middle Aged, Prognosis, Tachycardia, Sinus, Prevalence, Chi-Square Distribution, Statistics, Nonparametric
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