Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Current Concepts in Sick Sinus Syndrome: II. ECG Manifestation and Diagnostic and Therapeutic Approaches

Current Concepts in Sick Sinus Syndrome: II. ECG Manifestation and Diagnostic and Therapeutic... Abstract Sinus node dysfunction, or sick sinus syndrome (SSS), is defined as a disorder of impulse formation within the sinus node and impulse conduction out of the node. The disorder of impulse formation not only involves the sinus node but also affects subsidiary pacemakers.1-3 Thus, the term SSS reflects a more diffuse disease of the specialized conduction system involving the atria, the atrioventricular node, and occasionally the common His bundle and the bundle branches. This disorder is not of a single cause but has a constellation of causes (Table 1, in part I). Electrocardiographic (ECG) manifestations may predate the development of symptoms by several years. Once symptomatic sick sinus node dysfunction develops, recovery is unlikely and medical or surgical intervention is required. We will discuss ECG manifestations of sinus node dysfunction, newer techniques available for diagnosis of sinus node dysfunction, and current medical and surgical therapy. With early clinical recognition References 1. Brodsky M, Wu D, Denes P, et al: Arrhythmias documented by 24-hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease. Am J Cardiol 1977;39:390-395.Crossref 2. Ferrer MI: Rescue rhythms in the sick sinus syndrome: With specific reference to slow atrial rhythm. Cardiovasc Rev Rep 1981;2:149-151. 3. Ferrer MI: The etiology and natural history of sinus node disorders. Arch Intern Med 1982;142:371-372.Crossref 4. Gomes JAC, Kang PS, Matheson M, et al: Coexistence of sick sinus rhythm and atrial flutter-fibrillation. Circulation 1981;63:80-86.Crossref 5. Lown B: Electrical reversion of cardiac arrhythmias. Br Heart J 1967;29:469-489.Crossref 6. Mandel WJ, Hayakawa H, Danzig R, et al: Evaluation of sino-atrial node function in man by overdrive suppression. Circulation 1971;44:59-67.Crossref 7. Narula OS, Samet P, Javier RP: Significance of the sinus node recovery time. Circulation 1972;45:140-158.Crossref 8. Gupta PK, Lichstein E, Chadda KD, et al: Appraisal of sinus nodal recovery time in patients with sick sinus syndrome. Am J Cardiol 1974;34: 265-270.Crossref 9. Scheinman MM, Strauss HC, Abbott JA: Electrophysiologic testing for patients with sinus node dysfunction. J Electrocardiol 1979;12:216-220.Crossref 10. Gomes JAC, Kanz PS, El-Sharif N: The sinus node electrocardiogram in patients with and without sick sinus syndrome. Circulation 1982;66: 864-869.Crossref 11. Cramer M, Hariman RJ, Boxer R, et al: Electrocardiogram from the canine sinoatrial pacemaker recorded in vitro and in situ. Am J Cardiol 1978;42:939-945.Crossref 12. Strauss HC, Saroff AL, Bigger JT Jr, et al: Premature atrial stimulation as a key to the understanding of sinoatrial conduction in man: Presentation of data and critical review of the literature. Circulation 1973; 47:86-92.Crossref 13. Narula OS, Shantha N, Vasquez M, et al: A new method for measurement of sinoatrial conduction time. Circulation 1978;58:706-713.Crossref 14. Brethardt G, Seipel L: Comparative study of two methods of estimating sinoatrial conduction time in man. Am J Cardiol 1978;42:965-972.Crossref 15. Inoue D, Katsume H, Matsukubo H, et al: Comparative study of two methods of estimating sinoatrial conduction time in patients with abnormal sinus node function. Jpn Heart J 1982;23:25-38.Crossref 16. Jordan JL, Yamaguchi I, Mandel WJ: Studies on the mechanism of sinus node dysfunction in the sick sinus syndrome. Circulation 1978;57: 217-222.Crossref 17. Desai JM, Scheinman MM, Strauss HC, et al: Electrophysiologic effects of combined autonomic blockade in patients with sinus node disease. Circulation 1981;63:960-963.Crossref 18. Engel TR, Leddy C, Del Gonzalez A, et al: Electrophysiologic effects of hydralazine on sinoatrial function in patients with sick sinus node syndrome. Am J Cardiol 1978;41:763-769.Crossref 19. Weiss AT, Rod JL, Gotsman MS, et al: Hydralazine in the management of symptomatic sinus bradycardia. Eur J Cardiol 1981;12:261-270. 20. Parsonnet V: The proliferation of cardiac pacing. Medical, technical, and socioeconomic dilemmas. Circulation 1982;65:841-845.Crossref 21. Stone JM, Bhakta RD, Lutgen J: Dual chamber sequential pacing management of sinus node dysfunction: Advantages over single-chamber pacing. Am Heart J 1982;104:1319-1326.Crossref 22. Peters RW, Shafton E, Frank S, et al: Radiofrequency-triggered pacemaker: Uses and limitations. Ann Intern Med 1978;88:17-21.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Current Concepts in Sick Sinus Syndrome: II. ECG Manifestation and Diagnostic and Therapeutic Approaches

Archives of Internal Medicine , Volume 145 (4) – Apr 1, 1985

Loading next page...
 
/lp/american-medical-association/current-concepts-in-sick-sinus-syndrome-ii-ecg-manifestation-and-580B0D09J0

References (27)

Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1985.00360040156033
Publisher site
See Article on Publisher Site

Abstract

Abstract Sinus node dysfunction, or sick sinus syndrome (SSS), is defined as a disorder of impulse formation within the sinus node and impulse conduction out of the node. The disorder of impulse formation not only involves the sinus node but also affects subsidiary pacemakers.1-3 Thus, the term SSS reflects a more diffuse disease of the specialized conduction system involving the atria, the atrioventricular node, and occasionally the common His bundle and the bundle branches. This disorder is not of a single cause but has a constellation of causes (Table 1, in part I). Electrocardiographic (ECG) manifestations may predate the development of symptoms by several years. Once symptomatic sick sinus node dysfunction develops, recovery is unlikely and medical or surgical intervention is required. We will discuss ECG manifestations of sinus node dysfunction, newer techniques available for diagnosis of sinus node dysfunction, and current medical and surgical therapy. With early clinical recognition References 1. Brodsky M, Wu D, Denes P, et al: Arrhythmias documented by 24-hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease. Am J Cardiol 1977;39:390-395.Crossref 2. Ferrer MI: Rescue rhythms in the sick sinus syndrome: With specific reference to slow atrial rhythm. Cardiovasc Rev Rep 1981;2:149-151. 3. Ferrer MI: The etiology and natural history of sinus node disorders. Arch Intern Med 1982;142:371-372.Crossref 4. Gomes JAC, Kang PS, Matheson M, et al: Coexistence of sick sinus rhythm and atrial flutter-fibrillation. Circulation 1981;63:80-86.Crossref 5. Lown B: Electrical reversion of cardiac arrhythmias. Br Heart J 1967;29:469-489.Crossref 6. Mandel WJ, Hayakawa H, Danzig R, et al: Evaluation of sino-atrial node function in man by overdrive suppression. Circulation 1971;44:59-67.Crossref 7. Narula OS, Samet P, Javier RP: Significance of the sinus node recovery time. Circulation 1972;45:140-158.Crossref 8. Gupta PK, Lichstein E, Chadda KD, et al: Appraisal of sinus nodal recovery time in patients with sick sinus syndrome. Am J Cardiol 1974;34: 265-270.Crossref 9. Scheinman MM, Strauss HC, Abbott JA: Electrophysiologic testing for patients with sinus node dysfunction. J Electrocardiol 1979;12:216-220.Crossref 10. Gomes JAC, Kanz PS, El-Sharif N: The sinus node electrocardiogram in patients with and without sick sinus syndrome. Circulation 1982;66: 864-869.Crossref 11. Cramer M, Hariman RJ, Boxer R, et al: Electrocardiogram from the canine sinoatrial pacemaker recorded in vitro and in situ. Am J Cardiol 1978;42:939-945.Crossref 12. Strauss HC, Saroff AL, Bigger JT Jr, et al: Premature atrial stimulation as a key to the understanding of sinoatrial conduction in man: Presentation of data and critical review of the literature. Circulation 1973; 47:86-92.Crossref 13. Narula OS, Shantha N, Vasquez M, et al: A new method for measurement of sinoatrial conduction time. Circulation 1978;58:706-713.Crossref 14. Brethardt G, Seipel L: Comparative study of two methods of estimating sinoatrial conduction time in man. Am J Cardiol 1978;42:965-972.Crossref 15. Inoue D, Katsume H, Matsukubo H, et al: Comparative study of two methods of estimating sinoatrial conduction time in patients with abnormal sinus node function. Jpn Heart J 1982;23:25-38.Crossref 16. Jordan JL, Yamaguchi I, Mandel WJ: Studies on the mechanism of sinus node dysfunction in the sick sinus syndrome. Circulation 1978;57: 217-222.Crossref 17. Desai JM, Scheinman MM, Strauss HC, et al: Electrophysiologic effects of combined autonomic blockade in patients with sinus node disease. Circulation 1981;63:960-963.Crossref 18. Engel TR, Leddy C, Del Gonzalez A, et al: Electrophysiologic effects of hydralazine on sinoatrial function in patients with sick sinus node syndrome. Am J Cardiol 1978;41:763-769.Crossref 19. Weiss AT, Rod JL, Gotsman MS, et al: Hydralazine in the management of symptomatic sinus bradycardia. Eur J Cardiol 1981;12:261-270. 20. Parsonnet V: The proliferation of cardiac pacing. Medical, technical, and socioeconomic dilemmas. Circulation 1982;65:841-845.Crossref 21. Stone JM, Bhakta RD, Lutgen J: Dual chamber sequential pacing management of sinus node dysfunction: Advantages over single-chamber pacing. Am Heart J 1982;104:1319-1326.Crossref 22. Peters RW, Shafton E, Frank S, et al: Radiofrequency-triggered pacemaker: Uses and limitations. Ann Intern Med 1978;88:17-21.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Apr 1, 1985

There are no references for this article.