scholarly journals What is the Diagnosis?

2020 ◽  
Vol 33 (1) ◽  
pp. 37-39
Author(s):  
Cristiano de Oliveira Dietrich
Keyword(s):  
Sinus Node ◽  
Sinus Arrest ◽  
Node Disease ◽  
Sinus Node Disease ◽  
One Year ◽  
Double Chamber

A 83-year-old female implanted a double chamber pacemaker (Adapta DR) one year ago to threat a sinus node disease with symptomatic sinus arrest (up to 4,2s).

Partial Anomalous Pulmonary Venous Connection: Forty-Six Years of Follow-Up

2021 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Anne Kathrine M. Nielsen ◽  
Vibeke E. Hjortdal
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Node Disease ◽  
Sinus Node Disease ◽  
Patch Technique ◽  
Anomalous Pulmonary Venous Connection

Background: Surgical repair of partial anomalous pulmonary venous connection (PAPVC) may disturb the electrical conduction in the atria. This study documents long-term outcomes, including the late occurrence of atrial tachyarrhythmia and bradyarrhythmia. Methods: This retrospective study covers all PAPVC operations at Aarhus University Hospital between 1970 and 2010. Outcome measures were arrhythmias, sinus node disease, pacemaker implantation, pathway stenosis (pulmonary vein(s), intra-atrial pathway, and/or superior vena cava), and mortality. Data were collected from databases, surgical protocols, and hospital records until May 2018. Results: A total of 83 patients were included with a postoperative follow-up period up to 46 years. Average age at follow-up was 43 ± 21 years. During follow-up, new-onset atrial fibrillation or atrial flutter appeared in four patients (5%). Sinus node disease was present in nine patients (11%). A permanent pacemaker was implanted in seven patients (8%) at an average of 12.7 years after surgery. Pulmonary venous and/or superior vena cava obstruction was seen in five patients (6%). Stenosis was most prevalent in the two-patch technique, and arrhythmia was most prevalent in the single-patch technique. Sixty-seven (81%) of 83 patients had neither bradyarrhythmias nor tachyarrhythmias or pacemaker need. Conclusions: This study contributes important long-term data concerning the course of patients who have undergone repair of PAPVC. It confirms that PAPVC can be operated with low postoperative morbidity. However, late-onset stenosis, bradyarrhythmias and tachyarrhythmias, and need for pacemaker call for continued follow-up.

Bradyarrhythmias

2016 ◽  
Author(s):  
Inna Leybell ◽  
Liliya Abrukin
Keyword(s):  
Atrioventricular Block ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Treatment Options ◽  
Presenting Symptoms ◽  
Threatening Condition ◽  
Node Disease ◽  
Life Threatening ◽  
Sinus Node Disease ◽  
Sinoatrial Block

Bradyarrhythmias can present as an incidental electrocardiographic (ECG) finding or a life-threatening condition requiring immediate intervention. They are caused by sinus node disease or atrioventricular block. This review covers pathophysiology, stabilization and assessment, diagnosis and treatment options, and disposition and outcomes for patients with bradycardia. Figures in the review demonstrate characteristic ECG tracings. Tables list classifications of sinus node dysfunction as well as of sinoatrial and atrioventricular blocks, presenting symptoms, important information to elicit on history taking, various causes of bradycardia, and specific interventions for toxicologic etiologies. Key words: atrioventricular block, atropine, bradyarrhythmia, bradycardia, first-degree atrioventricular block, second-degree atrioventricular block, sinoatrial block, sinus bradycardia, sinus node disease, tachycardia-bradycardia syndrome, third-degree atrioventricular block This review contains 9 highly rendered figures, 7 tables, and 92 references.

scholarly journals PCV15 ATRIAL VERSUS DUAL CHAMBER PACING IN SINUS NODE DISEASE

2006 ◽  
Vol 9 (3) ◽  
pp. A123
Author(s):  
P Rucinski ◽  
A Kutarski ◽  
M Latek ◽  
B Kaminski ◽  
A Rubaj ◽  
...  
Keyword(s):  
Sinus Node ◽  
Dual Chamber ◽  
Dual Chamber Pacing ◽  
Node Disease ◽  
Sinus Node Disease

scholarly journals Electrophysiologic and electroanatomic characterization of the atria in sinus node disease: Evidence of diffuse atrial remodeling

2003 ◽  
Vol 41 (6) ◽  
pp. 121 ◽  
Author(s):  
Prashanthan Sanders ◽  
Joseph B. Morton ◽  
Peter M. Kistler ◽  
Neil C. Davidson ◽  
Azlan Hussin ◽  
...  
Keyword(s):  
Sinus Node ◽  
Atrial Remodeling ◽  
Node Disease ◽  
Sinus Node Disease

Atrial tachyarrhythmias in bradycardia–tachycardia syndrome: characterization and evolution

ESC CardioMed ◽  
2018 ◽  
pp. 1954-1957
Author(s):  
Luigi Padeletti ◽  
Roberto De Ponti
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Sinus Node ◽  
Ventricular Myocardium ◽  
Sinus Node Dysfunction ◽  
Ventricular Pacing ◽  
Atrial Tachyarrhythmia ◽  
Atrial Tachyarrhythmias ◽  
Node Disease ◽  
Sinus Node Disease

The association of sinus node disease and atrial tachyarrhythmias characterizes the bradycardia–tachycardia syndrome, which may result in an increased risk of heart failure, stroke, and death. Ageing and several cardiac and extracardiac diseases, which have the potential to affect both the atrial and the ventricular myocardium, can manifest their influence predominantly on the atria, leading to an atrial cardiomyopathy. In these cases, the same pathological process which leads to sinus node dysfunction can create a favourable substrate also for atrial tachyarrhythmias, which, if not present at the time of the initial diagnosis of the sinus node disease, can occur with an increasing prevalence during follow-up. In younger patients with no evident structural heart disease, a bradycardia–tachycardia syndrome may be the first clinical and unexpected manifestation of a still undiagnosed inherited genetic disease and therefore a specific diagnostic workup is necessary. In bradycardia–tachycardia syndrome, the most frequently encountered atrial tachyarrhythmia is atrial fibrillation, while typical atrial flutter is rarer. In peculiar subgroups of patients, other atrial tachyarrhythmias, such as atypical atrial flutter, macroreentrant or focal atrial tachycardia, may be present. In bradycardia–tachycardia syndrome, the evolution of atrial tachyarrhythmias clearly shows a worsening with an prevalence of associated atrial tachyarrhythmia over time. Pharmacological therapy for arrhythmias is of limited use, due to the concomitant sinus node dysfunction. The modality of pacing used to manage the sinus node disease has to be carefully chosen to minimize the evolution of atrial tachyarrhythmias. In fact, while ventricular pacing increases the incidence of atrial fibrillation and stroke, dual-chamber pacing with a specific algorithm for ventricular pacing minimization and prevention and treatment of atrial tachyarrhythmias reduces a composite endpoint of evolution to permanent atrial fibrillation, hospitalization, and death.

Sinus node disease: the role of electrophysiological testing

ESC CardioMed ◽  
2018 ◽  
pp. 1952-1953
Author(s):  
Dominic A. M. J. Theuns
Keyword(s):  
Sinus Node ◽  
Indirect Measurement ◽  
Conduction Time ◽  
Electrocardiographic Monitoring ◽  
Electrophysiological Testing ◽  
Yield Information ◽  
Electrophysiological Studies ◽  
Node Disease ◽  
Appropriate Therapy ◽  
Sinus Node Disease

Electrophysiological studies are indicated in patients with symptoms compatible with sinus node disease and in whom no documentation of the arrhythmia responsible for these symptoms has been obtained by prolonged electrocardiographic monitoring (e.g. Holter recording). In these patients, electrophysiological testing can yield information that may be used to guide appropriate therapy. The most useful measures of the overall sinus node function are the sinus node recovery time and the sinoatrial conduction time. In practice, the sinoatrial conduction time is rarely assessed because it represents an indirect measurement.

Syncope and neurocardiovascular instability

2017 ◽  
pp. 783-792
Author(s):  
Rose Anne Kenny ◽  
Conal Cunningham
Keyword(s):  
Vasovagal Syncope ◽  
Sinus Node ◽  
Physiological Changes ◽  
Younger Patients ◽  
Dual Pathology ◽  
Age Related ◽  
Common Causes ◽  
Node Disease ◽  
Sinus Node Disease ◽  
High Index Of Suspicion

The prevalence of syncope rises with age and is challenging because of atypical presentation, overlap with falls, and poor recall of events. Cardiac causes and multiple comorbidities are more common, and related morbidity and mortality are higher than in younger patients. Hence, a high index of suspicion for cardiovascular causes of falls and dual pathology will increase successful diagnosis and intervention. Age-related neurohumoral and physiological changes plus chronic diseases and medications often contribute to syncope. Orthostatic hypotension, carotid sinus syndrome, vasovagal syncope, postprandial syncope, sinus node disease, atrioventricular block, and ventricular tachycardia are other common causes. Management is often based on removing or reducing the predisposing or precipitating factors through medication adjustments, behavioural strategies, and more invasive cardiac interventions if indicated. It is often not possible to identify a single cause of syncope in older persons, hence apragmatic management of each diagnosis is recommended.

P5675Ischemic stroke in patient with sinus node disease in comparison to atrial fibrillation, bradycardia-tachycardia syndrome and other cardiac conditions: a nationwide cohort-study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Bodin ◽  
A Bisson ◽  
N Clementy ◽  
B Pierre ◽  
J Herbert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Sinus Node ◽  
Control Population ◽  
National Database ◽  
Control Group ◽  
Cardiac Condition ◽  
Node Disease ◽  
Sinus Node Disease

Abstract Atrial fibrillation (AF) may be associated with sinus node disease (SND) presenting as a brady-tachy syndrome (BTS), known to be at risk for embolic ischemic stroke (IS). It remains unclear whether the risk of IS is increased in patients with isolated SND. Methods This French longitudinal cohort study was based on the national database covering hospital care from for the entire population (PMSI) from 2010 to 2015. We compared incidences of IS in patients with a diagnosis of AF or SND to that in a control group of patients with a main diagnosis of cardiac condition (excluding those with AF or SND, history of stroke and mechanical valve or mitral stenosis). Results Of 1,732,412 patients included in the cohort, 1,601,435 (92.44%) had isolated AF, 102,849 (5.94%) had isolated SND and 28,128 (1.62%) had BTS. The control group with cardiac condition included 479,108 patients. Incidence of IS progressively increased when considering patients from the control population, patients with isolated SND, with BTS or with isolated AF (0.67%/yr, 1.95%/yr, 3.03%/yr and 5.48%/yr respectively). These differences were seen in all strata of CHA2DS2VASc score (table). SND patients with a CHA2DS2-VASc score ≥3 had a yearly incidence of IS >2%, comparable to AF population with a CHA2DS2-VASc score ≥1. Incidence (%/year) of ischemic stroke CHA2DS2-VASc AF population SND population “Control” population Women Men Women Men Women Men All scores 6.72% 4.37% 1.93% 1.96% 0.67% 0.68% Score = 0 – 1.960% – 1.211% – 0.217% Score = 1 2.337% 3.046% 0.538% 1.486% 0.166% 0.345% Score = 2 3.917% 4.499% 0.879% 1.541% 0.298% 0.580% Score = 3 7.572% 4.733% 2.207% 2.084% 0.541% 0.907% Score = 4 7.016% 4.820% 2.363% 2.305% 0.930% 1.278% Score = 5 6.725% 5.345% 2.845% 2.849% 1.249% 1.553% Score = 6 7.637% 7.543% 3.319% 4.109% 1.737% 2.031% Score = 7 10.196% 13.927% 4.663% 7.708% 2.346% 4.089% Score = 8 17.654% 12.607% 8.519% 11.904% 2.446% 2.355% Conclusion Patients with isolated SND had a lower risk of IS than patients with AF or BTS. However, SND patients had a non-neglectable risk of IS during follow-up which was higher than in a “control” population. Whether oral anticoagulation may bring a significant clinical benefit might be studied in patients with SND at highest risk of IS.

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