scholarly journals Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Amrish Deshmukh ◽  
Cevher Ozcan
Keyword(s):  
Multinodular Goiter ◽  
Carotid Sinus ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Chronotropic Incompetence ◽  
Obstructive Sleep ◽  
Symptomatic Bradycardia ◽  
Recurrent Sinus

Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes.

Bradycardia in athletes: clinical evaluation and management

ESC CardioMed ◽  
2018 ◽  
pp. 1971-1973
Author(s):  
Hein Heidbuchel
Keyword(s):  
Sinus Bradycardia ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Ionic Channel ◽  
Physiological Adaptation ◽  
Infiltrative Cardiomyopathy ◽  
Former Athletes ◽  
Underlying Causes ◽  
Symptomatic Bradycardia

Sinus bradycardia is very common in athletes. Recent evidence has shown that vagal hypertonia is not so much the mechanism behind this physiological adaptation, but rather intrinsic structural and ionic channel remodelling of the sinus node. Some athletes may present with extreme forms of bradycardia, such as a resting sinus rhythm of less than 30 beats per minute or sinus pauses of longer than 3 s. Even if asymptomatic, one may wonder how far this can still be considered ‘physiological’, since it is known that former athletes have a higher likelihood for the development of symptomatic bradycardia and the need for pacemaker implantation. Whereas asymptomatic athletes can participate in all sports, temporary cessation in those with symptoms is warranted to gauge resolution of bradycardia. If persistently symptomatic, pacemaker implantation needs to be considered. In those with extreme bradycardia but who are asymptomatic, a more intensified follow-up is recommended after exclusion of underlying causes (e.g. infiltrative cardiomyopathy, Lyme disease, or sarcoidosis).

Passagerer Herzschrittmacher

2018 ◽  
Vol 143 (12) ◽  
pp. 888-894
Author(s):  
Matthias Graf ◽  
Patrick Stiller ◽  
Martin Karch
Keyword(s):  
Acute Phase ◽  
Emergency Treatment ◽  
Sinus Node ◽  
Permanent Pacemaker ◽  
Sinus Node Dysfunction ◽  
Atrioventricular Conduction ◽  
Flow Chart ◽  
Temporary Pacemaker ◽  
Symptomatic Bradycardia

AbstractSymptomatic bradycardia is usually caused by abnormalities of atrioventricular conduction or sinus node dysfunction. Reversible and irreversible causes must be considered.Temporary pacemakers are used in the emergency treatment in case of severe bradyarrhythmia.They help to bridge the acute phase until spontaneous restoration of atrioventricular or sinus node function or –if spontaneous restoration fails- until a permanent pacemaker system was implanted.In the following article we discuss the commonly used temporary pacemaker systems. We demonstrate their use and correct programming by an illustrated step by step explanation. For troubleshooting a flow chart was added.

scholarly journals Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study

2018 ◽  
Vol 6 (12) ◽  
pp. 4053
Author(s):  
Sanjeev Bhat ◽  
Dharminder Kumar ◽  
Aditi Parimoo
Keyword(s):  
Sinus Node ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Single Chamber ◽  
Common Indication ◽  
Permanent Pacemaker Implantation ◽  
Pacing Mode ◽  
Node Disease ◽  
Sinus Node Disease ◽  
Pacemaker Insertion

Background: To determine the demographic details, indications, type of pacemakers and complications in patients undergoing the permanent pacemaker implantation.Methods: This was a single-center, retrospective study conducted in at a tertiary-care center in India. The records of 200 patients who had undergone implantation of permanent pacemakers in the period of May 2016 to April 2018 were reviewed.Results: Total 200 patients with mean age of 67 years were paced. Of these 120 (60%) were males. The mean duration of hospital stay was 6.5 days. Sinus node disease (105 patients, 52.5%) was the most common indication for permanent pacemaker insertion. Single chamber (VVIR) pacing mode (125 patients, 62.5%) was found to be the most common pacing mode used for pacemaker insertion. Among the 200 patients complications were observed in 8 patients (4%). Of these 8 patients, pneumothorax (4 patients, 2%) was found to be the most common complication for permanent pacemaker implantation followed by local site infection (1 patient, 0.5%). Only 1 patient (0.5%) died during the observation period of the study.Conclusions: Geriatric population with male predominance have observed to commonly undergo permanent pacemaker implantation. Sinus node disease in the elderly patients is the most common indication for cardiac pacing followed by atrioventricular block. Single chamber (VVIR) pacing mode is commonly used followed by dual chamber (DDDR) due to economic reasons in India. Pacemaker implantation is a relatively safe procedure with a low complication rate.

Outcomes of Permanent Pacemaker Implantation for Carotid Sinus Hypersensitivity in a District General Hospital with a Falls Fits Faints and Funny Turns Clinic

2002 ◽  
Vol 47 (6) ◽  
pp. 128-131 ◽  
Author(s):  
P. M. Karunaratne ◽  
P. A. Broadhurst ◽  
C. A. Norris
Keyword(s):  
General Hospital ◽  
Carotid Sinus ◽  
Pacemaker Implantation ◽  
Hospital Setting ◽  
District General Hospital ◽  
Permanent Pacemaker ◽  
Tilt Table ◽  
Carotid Sinus Massage ◽  
Carotid Sinus Hypersensitivity ◽  
Permanent Pacemaker Implantation

Permanent pacemaker implantation is considered for carotid sinus hypersensitivity with asystolic pause of >3 seconds during carotid sinus massage, with or without associated systolic blood pressure drop of >50 mmHg. Aims: To assess the outcome of treatment with dual chamber permanent pacemaker implantation for carotid sinus hypersensitivity in a district general hospital and to compare our practice with available national data. Methods: Patients presenting with syncope, dizziness or unexplained falls were initially assessed as outpatient and investigations, commonly cardiovascular were performed including tilt table test with carotid sinus massage to look for carotid sinus hypersensitivity, vasovagal syncope and postural hypotension. A retrospective analysis was performed on patients who had pacemaker implantations for carotid sinus hypersensitivity. Results: Fifty pacemaker implantations were performed, 14 (28%) were for carotid sinus hypersensitivity. Mean follow-up period was 10 months. Age range was 56–88 (mean = 71.9) years. In the eighteen months prior to pacemaker implantation, 71.4% of patients had syncope, 64%> dizziness and 50% had unexplained falls. Following pacemaker implantations, only 2 (14.3 %) had symptoms. Scottish national figures show 13.6% of all new pacemaker implants were for carotid sinus hypersensitivity, and in district general hospitals this was 16%. Conclusions: Health benefits for patients presenting with syncope dizziness and falls can be achieved by cardiovascular investigations including tilt table testing. We have shown carotid sinus hypersensitivity is successfully treated with pacemaker implantation in a district general hospital setting and this type of clinic has an impact on the rate and type of new pacemaker implantation.

scholarly journals Reduction of falls and fractures after permanent pacemaker implantation in elderly patients with sinus node dysfunction

EP Europace ◽  
2016 ◽  
Vol 19 (7) ◽  
pp. 1220-1226 ◽  
Author(s):  
Roman Brenner ◽  
Peter Ammann ◽  
See-Il Yoon ◽  
Stefan Christen ◽  
Jens Hellermann ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Sinus Node Dysfunction ◽  
Permanent Pacemaker Implantation

Sinus node disease: ECG patterns and diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1949-1952
Author(s):  
Tatjana Potpara
Keyword(s):  
Carotid Sinus ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Cardiac Pacemakers ◽  
Carotid Sinus Hypersensitivity ◽  
Electrophysiological Studies ◽  
Node Disease ◽  
Structural Disease ◽  
Exit Block

A healthy sinus node (SN) is the physiological principal site of electrical impulse formation in the heart, owing to its ability to sustain a regular generation of spontaneous depolarization at faster rates than other latent cardiac pacemakers. Structural disease (or senescence) of the SN and sinoatrial junction may cause SN disease (SND). The electrocardiographic (ECG) manifestations of SND are usually intermittent and can be easily missed. The ECG patterns of SND include: (1) periods of spontaneous, often pronounced, sinus bradycardia; (2) sinus pause due to sinus arrest or sinoatrial exit block; and (3) tachycardia-bradycardia syndrome. There is no standardized set of diagnostic criteria for SND. Since the symptoms of SND are non-specific, and the initial ECG may not be diagnostic, establishing a correlation between symptoms and the underlying heart rhythm at the time of symptoms is essential for the diagnosis, provided that any potentially reversible cause(s) of transient SN dysfunction have been excluded (or identified and treated). Invasive electrophysiological studies are not routinely used for the evaluation of SND, due to a limited sensitivity, and may be considered in patients with a mismatch of symptoms and ECG findings. When reversible causes have been excluded, SND should be distinguished from ‘physiological’ bradycardia (particularly in well-trained athletes), neurocardiogenic syncope with a pronounced cardioinhibitory component, or carotid sinus hypersensitivity. Carotid sinus hypersensitivity can be established by carotid sinus massage resulting in a pause of longer than 3 s or a symptomatic drop in blood pressure, or both.

Classification of bradyarrhythmias

ESC CardioMed ◽  
2018 ◽  
pp. 1931-1935
Author(s):  
Bulent Gorenek ◽  
Gulmira Kudaiberdieva
Keyword(s):  
Clinical Presentation ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Sinus Arrest ◽  
Chronotropic Incompetence

This chapter presents the classification of bradyarrhythmias by electrocardiography, electrophysiological and anatomical levels of blocks, clinical presentation, and aetiology. Sinus node dysfunction, including sinus bradycardia, sinus pause and sinus arrest, sinoatrial blocks, chronotropic incompetence, and bradycardia–tachycardia syndrome, and atrioventricular blocks are discussed. A comprehensive aetiology of bradyarrhythmias is presented, including congenital, acquired, and iatrogenic causes.

Sign in / Sign up

Export Citation Format

Share Document