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Chin Med J (Taipei) 1997;60:117-23.
1Division of Cardiology, Department of Medicine; 2Division of Cardiovascular Surgery, Department of Surgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, R.O.C.
We present here, the case of a 22-year-old male suffering from persistent tachycardia for the past 3 years. His resting pulse rate was rarely below 100 beats/min, and it frequently increased to as high as 150 beats/min even after a minimal of activity. Associated symptoms included palpitation, chest tightness, dyspnea and presyncope, either during rest or with exercise. Propranolol and verapamil could not control the tachycardia. The application of radiofrequency energy to an area in the superior right atrium that demonstrated a discrete electrogram with earliest endocardial activation during tachycardia resulted in a decrease in sinus rate from 120 beats/min to 70 beats/min. Follow-up on Holter monitor, performed one month later, demonstrated an average heart rate of 84 beats/min (range 60-125). In exercise tolerance test, the patient exercised for 9 minutes, achieving a maximum heart rate of 140 beats/min. This patient remained asymptomatic without any antiarrhythmic drug during the 3-month follow-up period.
Medical management in case of patients showing disabling inappropriate sinus tachycardia refractory, sinus node modification could be considered as an suitable alternative to complete atrioventricular junctional ablation.
[Chin Med J (Taipei) 1997;60:117-23.]
Keywords: catheter ablation, inappropriate sinus tachycardia, sinus node
Received: August 23, 1996.
Accepted: May 7, 1997.
Address reprint requests to: Shih-Huang Lee, M.D., Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih-Lin, Taipei, Taiwan, R.O.C.
Copyright: 1997, Chinese Medical Association (Taipei)