Treatment of inappropriate sinus tachycardia with ivabradine in a patient with postural orthostatic tachycardia syndrome and a dual chamber pacemaker.
We present the case of a 44-year-old woman with postural orthostatic tachycardia syndrome (POTS) and a dual chamber pacemaker. The patient suffered from inappropriate sinus tachycardia that had been resistant to treatment with traditional rate-slowing medications. Ivabradine--the specific sinus node I(f) current inhibitor--was used to successfully lower the heart rate. The patient had no evidence of POTS on repeat autonomic function testing, and there was a corresponding symptomatic benefit. We propose that this class of drugs, the use of which is established as antianginals, should be considered in patients with resistant inappropriate sinus tachycardia.
Khan
Sitara
S
Cardiothoracic Department, St. Thomas' Hospital, Westminster Bridge Road, London, United Kingdom.
Hamid
Shoaib
S
Rinaldi
Christopher
C
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001552:Benzazepines / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D000077550:Ivabradine; D010138:Pacemaker, Artificial; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications* / Q000628:therapy*; D013616:Tachycardia, Sinus / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D001552:Benzazepines; D000077550:Ivabradine