Sinner defeated Medvedev for the second time in three weeks, having also overcome the Russian in the Beijing final at the start of October.

Medvedev was attempting to retain the title he won last year in Austria but Sinner nudged ahead in the final set, taking his ninth break point of an 18-minute game for a 3-1 lead.

Former world number one Medvedev broke back the following game only to immediately again drop serve, allowing Sinner to close out victory in just over three hours.

"It took a lot of mental and physical stuff," said Sinner, who retrieved a break in the opening set and saved two set points before snatching the tie-break.

"I think we both served very well the first set. I managed somehow to get back on serve when he was a break up, because I felt like he was serving really good. I found a way in the first set."

Medvedev, who beat Sinner in the finals in Miami and Rotterdam earlier this year, hit back with a couple of breaks in the second set to force a decider.

"Second set, I felt like he was trying to get into the rally a little bit more and I was hustling a little bit," said Sinner.

The fourth-ranked Sinner raised his level in the final set, finally putting away Medvedev to capture his 10th career title.

"In the third set, I tried to step up a little bit. I had a lot of breakpoints, I couldn't use them and then at the end, I used them so I'm very happy," said Sinner.

"Obviously to finish the match, it was really a mental thing, but I'm very happy about how I managed today and very happy for another title."

Both players are in the draw for next week's Paris Masters. Sinner and Medvedev have already qualified for the ATP Finals in Turin.