Sinus Node Dysfunction - Biotech, Pharma and Life Science Channel
Sinus node dysfunction refers to a number of conditions producing physiologically inappropriate atrial rates. Symptoms may be minimal or include weakness, palpitations, and syncope. Diagnosis is by ECG. Symptomatic patients require a pacemaker.
Sinus node dysfunction includes inappropriate sinus bradycardia, alternating bradycardia and atrial tachyarrhythmias (bradycardia-tachycardia syndrome), sinus pause or arrest, and sinoatrial (SA) exit block. Sinus node dysfunction affects mainly the elderly, especially those with another cardiac disorder or diabetes.
Sinus pause is temporary cessation of sinus node activity, seen on ECG as disappearance of P waves for seconds to minutes. The pause usually triggers escape activity in lower pacemakers (eg, atrial or junctional), preserving heart rate and function, but long pauses cause dizziness and syncope. In SA exit block, the SA node depolarizes, but conduction of impulses to atrial tissue is impaired.
The most common cause of sinus node dysfunction is idiopathic SA node fibrosis, which may be accompanied by degeneration of lower elements of the conducting system. Other causes include drugs, excessive vagal tone, and many ischemic, inflammatory, and infiltrative disorders.
Treatment is pacemaker implantation. Risk of AF is greatly reduced when a physiologic (atrial or atrial and ventricular) pacemaker rather than a ventricular pacemaker is used. Newer dual chamber pacemakers that minimize ventricular pacing may further reduce risk of AF. Antiarrhythmic drugs may prevent paroxysmal tachyarrhythmias after pacemaker insertion.
Source; Merck Manuals
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