Abstract：
BACKGROUND: Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta-blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation.
METHODS: This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.
RESULTS: The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24-h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24-h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.
CONCLUSIONS: This is the first case series reporting the acute and long-term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE-guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
METHODS: This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.
RESULTS: The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24-h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24-h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.
CONCLUSIONS: This is the first case series reporting the acute and long-term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE-guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
摘要：
背景：不适当的窦性心动过速（IST）是一种常见病，经常不耐受β受体阻滞剂或伊伐布雷定，并且在消融策略中并发症发生率很高；我们描述了窦房结（SN）调制的替代解剖学方法。
方法：本回顾性研究描述了来自两个中心的6例患者的病例系列，这些患者被诊断为有症状的IST正在进行SN消融术。
结果：平均年龄为40.6±13.9岁；6例患者中有5例为女性，100%的患者报告心悸,66%报告头晕，24小时动态心电图的平均心率(HR)为93.2±7.9bpm.使用标准布鲁斯方案进行压力测试的第一阶段的HR为150±70bpm，消融后24小时Holter的平均HR为75±5.6bpm,Bruce方案运动压力测试第1阶段的心率HR为120±10bpm.
结论：这是第一个病例系列报告了在心内回波描记术（ICE）指导下，一种新的SN调制解剖方法治疗以弓形脊（AR）为目标的IST的急性和长期结果。新的解剖ICE引导导管消融方法旨在识别AR的最早激活，RF损伤向其间隔区延伸，对于有症状的IST难以接受药物治疗的患者，似乎可以有效且安全地调节SN。
方法：本回顾性研究描述了来自两个中心的6例患者的病例系列，这些患者被诊断为有症状的IST正在进行SN消融术。
结果：平均年龄为40.6±13.9岁；6例患者中有5例为女性，100%的患者报告心悸,66%报告头晕，24小时动态心电图的平均心率(HR)为93.2±7.9bpm.使用标准布鲁斯方案进行压力测试的第一阶段的HR为150±70bpm，消融后24小时Holter的平均HR为75±5.6bpm,Bruce方案运动压力测试第1阶段的心率HR为120±10bpm.
结论：这是第一个病例系列报告了在心内回波描记术（ICE）指导下，一种新的SN调制解剖方法治疗以弓形脊（AR）为目标的IST的急性和长期结果。新的解剖ICE引导导管消融方法旨在识别AR的最早激活，RF损伤向其间隔区延伸，对于有症状的IST难以接受药物治疗的患者，似乎可以有效且安全地调节SN。
