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J Thorac Cardiovasc Surg 2005;130:598-599
© 2005 The American Association for Thoracic Surgery

Brief Communication

A minimally invasive surgical treatment for inappropriate sinus tachycardia

^a Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Mo
^b Department of Medicine, Washington University School of Medicine, St Louis, Mo

Received for publication November 10, 2004; accepted for publication December 17, 2004.

^_* Address for reprints: Ralph J. Damiano, Jr, MD, John M. Schoenberg Professor of Surgery, Chief of Cardiac Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, 3108 Queeny Tower, One Barnes-Jewish Hospital Plaza, St Louis, MO 63110 (Email: damianor@msnotes.wustl.edu).

The first 20% of the full text of this article appears below.

Inappropriate sinus tachycardia (IST) is a rare disorder characterized by an abnormally elevated heart rate at rest and an exaggerated rate response to physical activity. In most patients the condition is refractory to dietary modification and medical management. Despite reports of successful catheter ablation of the sinoatrial node, patients do fail to respond to this therapy. ^1,2 This report describes a case of IST, refractory to medical therapy and catheter ablation, that was successfully treated surgically with a novel minimally invasive off-pump approach.

Clinical Summary

A 34-year-old woman was referred for surgical treatment of IST. She had initially presented at the age of 28 years with reports of palpitations associated with chest pain and shortness of breath. An echocardiogram and a cardiac catheterization showed unremarkable results. Holter monitoring revealed that she was in sinus rhythm with rates between 100 and 110 beats/min. Symptoms of palpitations were correlated with sinus tachycardia at rates between 120 and 150 beats/min. An electrophysiologic study demonstrated dual atrioventricular nodal physiology with sustained atrioventricular reentry. . . . [Full Text of this Article]

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