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Often sinus node dysfunction produces no symptoms, especially early in the disease course. Signs and symptoms usually appear in more advanced disease and more than 50% of patients will present with syncope or transient near-fainting spells as well as bradycardias that are accompanied by rapid heart rhythms, referred to as tachycardia-bradycardia syndrome [4] [5] Other presenting signs or ...
Sinus node dysfunction also known as sick sinus syndrome is a group of irregular heartbeat conditions caused by faulty electrical signals of the heart. When the heart's sinoatrial node is defective, the heart's rhythms become abnormal—typically too slow or exhibiting pauses in its function or a combination, and very rarely faster than normal ...
Sinus bradycardia is commonly seen in normal healthy persons and athletes in the absence of pathophysiological diseases or conditions. [1] Different factors or etiologies could lead to the dysfunction of the sinus node, causing a malformation or prolongation of the impulse. In terms of pathophysiological diseases, sinus rhythm may be caused by:
Junctional rhythm is seen equally in men and women, and can be seen intermittently in young children and athletes, especially during sleep. It occurs commonly in patients with sinus node dysfunction. 1/600 cardiology patients over the age of 65 have sinus node dysfunction. [1]
Sinus pause and arrest involve slowing or arresting of automatic impulse generation from the sinus node. This can lead to asystole or cardiac arrest if ventricular escape rhythms do not create backup sources of cardiac action potentials. [2] Sinoatrial exit block is a similar non-respiratory phenomenon of temporarily lost sinoatrial impulses.
Inappropriate sinus tachycardia (IST) is defined as sinus tachycardia that is not caused by identifiable medical ailments, a physiological reaction, or pharmaceuticals (a diagnosis of exclusion) and is accompanied by symptoms, frequently invalidating and affecting quality of life. [2]
Impulses from the sinus node reach the atrioventricular node which acts as the secondary pacemaker. The cells of the AV node normally discharge at about 40–60 beats per minute, and are called the secondary pacemaker. Further down the electrical conducting system of the heart is the Bundle of His.
Treatment is rarely required because, in most cases, it is asymptomatic. If symptoms develop, medication can be pursued for symptomatic relief. In the setting of suspected sinus node dysfunction manifesting as wandering atrial pacemaker, evaluation for pacemaker placement may be done due to sinus node damage. [2]