Document Detail


Sick sinus syndrome.
MedLine Citation:
PMID:  12180244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sinus-node dysfunction is common in the elderly and, in most cases, does not cause any symptoms. Despite the high number of laboratory investigations, most diagnoses of sinus-node dysfunction are made by 12-lead electrocardiography, which shows severe sinus bradycardia, sinus arrest, or sinoatrial block. Continuous electrocardiographic monitoring, exercise testing, and electrophysiologic investigations (including pharmacologic interventions to cause complete autonomic blockade) are sometimes useful in detecting transient or latent sinus-node abnormalities. The term sick sinus syndrome should be reserved for patients with symptomatic sinus-node dysfunction. Sick sinus syndrome has a protean presentation with variable degrees of clinical severity. Symptoms are often intermittent, changeable, and unpredictable. Because these symptoms can be observed in several other diseases, none are specific to sick sinus syndrome. Owing to the nonspecific nature of its symptoms, sick sinus syndrome can be diagnosed only when clear electrocardiographic signs corroborate symptoms. In the absence of a demonstrable link between signs and symptoms, a diagnosis can be presumed only when signs of severe sinus dysfunction are present and when every other possible cause of symptoms has been excluded carefully. Sinus-node dysfunction frequently is associated with diseases of the autonomic nervous system, and autonomic reflexes play a major role in the genesis of syncope. Survival does not seem to be affected by sick sinus syndrome. Atrioventricular block, chronic atrial fibrillation, and systemic embolism are major pathologic conditions that affect the outcome of the syndrome. Treatment should be aimed at controlling morbidity and relieving symptoms. Cardiac pacing is the most powerful therapy; physiologic pacing (atrial or dual-chamber) has been shown definitively to be superior to ventricular pacing.
Authors:
Michele Brignole
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinics in geriatric medicine     Volume:  18     ISSN:  0749-0690     ISO Abbreviation:  Clin. Geriatr. Med.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-08-15     Completed Date:  2002-12-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8603766     Medline TA:  Clin Geriatr Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  211-27     Citation Subset:  IM    
Affiliation:
Department of Cardiology and Arrhythmologic Centre, Ospedali Riuniti, Via Don Bobbio, 16032 Lavagna, Italy. mbrignole@ASL4.liguria.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Clinical Trials as Topic
Humans
Middle Aged
Prospective Studies
Sick Sinus Syndrome* / diagnosis,  physiopathology,  therapy
Sinoatrial Block / etiology,  physiopathology
Sinoatrial Node / physiopathology*
Telemetry

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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