| Implications of marked fatty infiltration around and in the atrophic atrioventricular node in elderly patients with permanent pacemaker implantation for symptomatic sick sinus syndrome. | |
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MedLine Citation:
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PMID: 10943612 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The present study undertook an extensive analysis of the histopathological findings of the atrioventricular conduction system in 14 elderly patients treated with permanent pacemakers for sick sinus syndrome (SSS). Special attention was given to the lowest Wenckebach block points of atrioventricular conduction during rapid atrial pacing, and ventricular rate or duration of ventricular pause during chronic atrial fibrillation. An electrophysiological study (EPS) was conducted under sinus rhythm in 13 patients and under junctional escape rhythm in 1 patient. Three of the 14 cases showed a lower Wenckebach block point of 130 beats/min or less. Two of these 3 cases showed excessive fatty infiltration around the atrionodal junction area and into the atrophic atrioventricular node (AVN) itself. Of the 6 patients who had chronic atrial fibrillation after pacemaker implantation, 2 cases showed a slow ventricular response of less than 60 beats/min and/or a long ventricular pause of 3.3 s. One of the 2 cases showed a lower Wenckebach block point of 130 beats/min at the time of EPS. The other, who later progressed to idiopathic atriomegaly, also showed marked fatty infiltration around the AVN. This fatty lesion was closely associated with diffuse disruption of the muscular fibers connecting the atrophic AVN with the atrium. In addition, most of the remaining cases also had an atrophic AVN. In conclusion, a sparse or absent atrionodal connection and an atrophic AVN due to excessive fatty infiltration in the atrionodal transitional area should be investigated in atrioventricular conduction disturbances in the elderly with SSS. |
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Authors:
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K Chida; T Imai; T Taniguchi; S Maeda; C Watanabe; Y Esaki; K Takubo; S Ohkawa |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Japanese circulation journal Volume: 63 ISSN: 0047-1828 ISO Abbreviation: Jpn. Circ. J. Publication Date: 1999 May |
Date Detail:
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Created Date: 2000-08-29 Completed Date: 2000-08-29 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7806868 Medline TA: Jpn Circ J Country: AUSTRALIA |
Other Details:
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Languages: eng Pagination: 343-9 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Atrioventricular Node / metabolism, pathology* Atrophy Female Humans Lipid Metabolism Male Pacemaker, Artificial* Sick Sinus Syndrome / metabolism, pathology*, therapy |
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