diagnosis and treatment of sick sinus syndrome

Therefore, a pacemaker is implanted before drug therapy is begun for theĪtrial arrhythmic disease Hypocinetic arrhythmias Present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. However, because both bradyarrhythmias and tachyarrhythmias may be Of sick sinus syndrome may be revealed by tilt table testing.Īrtificial pacemakers have been used in the treatment of sick sinus syndrome.īradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias In which pacemaker dysfunction is associated with disturbances of rhythm orĬonduction: the most classical of these associations is represented by theĪmbulatory monitoring of the electrocardiogram (ECG) may be necessary becauseĪtrial fibrillation with slow ventricular responseĪ prolonged asystolic period after a period of tachycardiasĮlectrophysiologic tests are no longer used for diagnostic purposes because of In this nosological picture of the sinus node disease there are some syndromes The bradycardias that appear in the mature age (from 40 to 60 years). sinus-atrial blocks (1st, 2nd and 3rd degree).ī) The second group is represented by isolated sinus bradycardias, characterizedīy a frequency lower than 55 / min., underlining that in these cases they

Organic sinus lesions, can in turn be divided into two groups:Ī) The first one including the electrocardiographic aspects: The chronic forms, mostly stable and irreversible, usually the expression of The acute phase of a myocardial infarction) or, finally, following cardioversion. Metabolic disorders (hyperkalemia, ex.) or also due to excessive release ofĪcetylcholine at the parasympathetic terminations during acute ischemia (eg in The acute forms, usually reversible and transitory, include the syndromesĪrising in the course of pharmacological intoxications (from quinidine,īeta-blockers, lidocaine, amiodarone, digital, etc.), but also as a result of These syndromes may occur in acute or chronic form: Ventricular chambers contraction, causing a deficit of pump activity, would cause death byĬardiovascular collapse.This is due to the fact that the ventricles if theyĬontract quickly do not have time to fill and pump Sick sinus syndrome (SSS) See, in the supraventricular tachyarrhythmias where an excessive rhythm of the Potentials is shorter, but its physiological function is important, as we will Refractory period, therefore, longer, since the frequency of its action Refractory period, however, is a minimum interval between two action potentials,ĭuring which the common myocardium fails to be stimulated. Pacemaker only when the other path markers are, so to speak, turned off. (NAV), which is however equipped with a slower automatism, so it can act as a Node are equipped with automatic activity: among these the Atrioventricular Node There are other structures that like the sinus Thus, through a sodium-calcium exchange, the myocardial cells are excited (hence the use ofĬalcium antagonists in therapy to adjust the rhythm). Triggering the action potentials in the common myocardium. The sinus node (NS) consists of these cells and as it isĮquipped with the fastest automatism it controls the cardiac activity, Tachycardia-bradycardia syndrome is often associated with ischemic heart disease The arrhythmia alternates between slow and fast heart rates. Tachycardia-bradycardia syndrome is a variant of sick sinus syndrome in which ('SND'), is a group of abnormal heart rhythms (arrhythmias) presumably caused byĪ malfunction of the sinus node, the heart's primary pacemaker. Sick sinus syndrome (SSS), also called sinus dysfunction, or sinoatrial node disease Notes by dr Claudio Italiano Sick sinus syndrome I agree Sick sinus syndrome (SSS) or sinoatrial node disease (SAD) and other bradyarrhythmias

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Diagnosis and treatment of sick sinus syndrome