Sick Sinus Syndrome

A condition caused by dysfunctions related to the SINOATRIAL NODE including impulse generation (CARDIAC SINUS ARREST) and impulse conduction (SINOATRIAL EXIT BLOCK). It is characterized by persistent BRADYCARDIA, chronic ATRIAL FIBRILLATION, and failure to resume sinus rhythm following CARDIOVERSION. This syndrome can be congenital or acquired, particularly after surgical correction for heart defects.

Also Known As:

Sick Sinus Node Syndrome; Sinus Node Disease; Dysfunction, Sinus Node; Dysfunctions, Sinus Node; Sinus Node Diseases; Syndrome, Sick Sinus; Sinus Node Dysfunction

Networked: 1011 relevant articles (45 outcomes, 90 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Atrial Fibrillation
2.	Bradycardia
3.	Atrioventricular Block
4.	Tachycardia (Tachyarrhythmias)
5.	Cardiac Arrhythmias (Arrythmia)

Experts

1.	Mohler, Peter J: 10 articles (01/2020 - 05/2005)
2.	Hund, Thomas J: 8 articles (07/2014 - 10/2008)
3.	Ellenbogen, Kenneth A: 7 articles (01/2021 - 06/2003)
4.	Joung, Boyoung: 6 articles (04/2020 - 11/2010)
5.	Makita, Naomasa: 5 articles (07/2017 - 05/2009)
6.	Lee, Moon-Hyoung: 5 articles (01/2015 - 08/2009)
7.	Pak, Hui-Nam: 5 articles (01/2015 - 11/2010)
8.	Anderson, Mark E: 5 articles (08/2014 - 10/2008)
9.	Lei, Ming: 5 articles (01/2013 - 09/2005)
10.	Wilde, Arthur A M: 5 articles (04/2011 - 05/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Sick Sinus Syndrome:

1.	Dichlorodiphenyldichloroethane (DDD)IBA 12/01/2002 - "Although atrial pacing is a more physiological mode of stimulation in sinus node dysfunction, the pacing modes most often are used DDD and VVI. The aim of our study was to demonstrate that AAI/AAIR pacing is effective and safe by analyzing the complications and mortality of this pacing mode in a long-term follow-up study. " 10/01/1988 - "Palpitation and general wellbeing were significantly improved during DDD pacing in the eight patients with sick sinus syndrome. " 01/01/2015 - "According to the current guidelines, atrioventricular (DDD) pacing is superior to atrial pacing (AAI) in the treatment of sick sinus syndrome (SSS). " 12/01/2003 - "Another trial the Pacemaker Selection in the Elderly (PASE) did suggest that for sinus node disease, DDD-R pacing may lead to an improvement in quality of life mainly early post implant. " 09/03/2021 - "A subject of the study is a 74-year-old woman with a sick sinus syndrome (SSS) and a previously implanted physiological DDD/R pacemaker. "
2.	Isoproterenol (Isoprenaline)FDA LinkGeneric 01/01/2014 - "The mechanism of isoprenaline exerting its effects on cardiac pacemaking and driving in sick sinus syndrome is controversial and unresolved. " 01/01/2014 - "Isoprenaline: a potential contributor in sick sinus syndrome--insights from a mathematical model of the rabbit sinoatrial node." 08/01/1986 - "Thus, carotid sinus massage and, to some extent, isoprenaline administration appear simple bedside tests which may be helpful in identifying the underlying mechanism of sick sinus syndrome." 09/01/2004 - "(1) Electrophysiologic study was positive in 107 patients (69%); (2) sinus node dysfunction was noted in 9 patients (6%); (3) atrioventricular conduction disturbances were noted in 2 patients (1%); (4) vasovagal reaction which associated a junctional bradycardia and a fall of arterial blood pressure and which reproduced spontaneous symptoms was provoked by isoproterenol infusion in 21 patients (14%); (5) sustained atrial fibrillation was induced in 23 patients (15%); and (6) paroxysmal junctional tachycardia was induced in 52 patients (34%). " 02/01/1996 - "the blunted responses of the heart rate to atropine as well as isoproterenol further suggested the presence of sick sinus syndrome. "
3.	Disopyramide (Norpace)FDA LinkGeneric 06/01/1991 - "The aim of this study was to assess the effect of delayed release Disopyramide 500 mg daily on sinus node function in 12 subjects with sinus node dysfunction and supraventricular and/or ventricular excitability. " 07/01/1982 - "Electrophysiological effects of disopyramide phosphate in patients with sinus node dysfunction." 03/01/1982 - "Disopyramide has the potential to suppress sinus node function and, therefore, must be used cautiously in patients with the sick sinus syndrome. " 02/01/1979 - "Disopyramide should be administered cautiously to patients with sinus node dysfunction, particularly those with sinus pauses, SA exit block or secondary pauses." 02/01/1979 - "The electrophysiologic effects of intravenously administered disopyramide (2 mg/kg) on three parameters of sinus node function were examined in 16 symptomatic patients with sinus node dysfunction. "
4.	Atropine FDA LinkGeneric 04/01/1981 - "Twenty other patients with sinus node disease underwent electrophysiologic studies both before and after i.v. administration of 0.04 mg of atropine alone. " 11/01/1994 - "Sick sinus syndrome with normal atropine response--a case report." 05/01/1991 - "His prolonged CSNRT remained high after atropine administration, indicating abnormal automaticity such as that seen in sick sinus syndrome. " 01/01/1988 - "An abdominal wall derived fetal electrocardiogram and the failure of the sinus rate to increase in response to maternal exercise or I.V. atropine suggested sinus node dysfunction. " 01/01/1985 - "[Diagnostic value of the atropine test in the sick sinus syndrome]."
5.	Propranolol (Inderal)FDA LinkGeneric 09/01/1988 - "[Paradoxical shortening of the time of restoration of sinoatrial node function after administration of obsidan in patients with sick sinus syndrome]." 05/01/1988 - "The electrophysiological effects of intravenous propranolol (0.15 mg/kg) were studied in 26 patients with sinus node dysfunction (SND group) and 9 patients with normal sinus node function (control group). " 05/01/1988 - "Electrophysiological effects of propranolol in patients with sinus node dysfunction." 09/01/1976 - "The electrophysiologic effects of intravenously administered propranolol (0.1 mg/kg) on three parameters of sinus node function were examined in ten symptomatic patients with sinus node dysfunction. " 09/01/1976 - "Electrophysiologic effects of propranolol on sinus node function in patients with sinus node dysfunction."
6.	Adenosine Triphosphate (ATP)IBA 07/01/2005 - "Our aim was to study ATP efficacy in patients with brady-tachy form of sinus node disease (SND), identifying clinical factors, ATA characteristics, and device features predicting ATP efficacy. " 05/01/1984 - "The purpose of this paper is to investigate whether the inhibitory action of purinic compounds (striadyne: STR) on the sinus node is quantitatively different on a pathological sinus node in comparison to a normal one and thus whether it is possible, as suggested by other authors, to use STR as a pharmacological test in the diagnosis of sick sinus syndrome (SSS). " 12/01/1993 - "The clinical value of rapid intravenous injection of adenosine triphosphate (ATP, Adephos Kowa # L3, CAS 56-65-5) for assessing sinus node function was examined in 5 patients with sick sinus syndrome (SSS) and 6 normal controls. " 04/01/2006 - "The present study retrospectively evaluated the reliability of detecting atrial tachyarrhythmias (ATA), the efficacy of automatic atrial antitachycardia pacing (ATP) and the performance of atrial preventive pacing (APP) algorithms in an implanted antitachycardia DDDRP pacemaker for patients with sick sinus syndrome and paroxysmal ATA. " 07/01/2006 - "The PITAGORA trial was a multi-centre, randomized, cross-over study aimed at comparing two different ATP modes for atrial tachyarrhythmia (AT) termination in patients suffering from sinus node disease (SND). "
7.	Amiodarone (Amiodarona)FDA LinkGeneric 01/01/2016 - "SEVERE AMIODARONE-INDUCED BRADICARDIA CONCEALES SICK SINUS SYNDROME: CASE REPORT." 01/01/2013 - "Only the amiodarone group had sick sinus syndrome (n=4, 22%, P=0.03) and abnormal (>550ms) corrected SAN recovery time (n=5, 29%; P=0.02). " 08/01/1987 - "Effect of amiodarone on sinus node function in patients with sick sinus syndrome." 12/01/2010 - "Amiodarone however caused sinus node dysfunction and temporary electrode pacing had to be used. " 01/01/1987 - "We caution that the heart rate be monitored carefully when therapy with amiodarone is initiated in patients likely to have sick sinus syndrome. "
8.	Theophylline (Theon)FDA LinkGeneric 04/01/1993 - "The results suggest that oral theophylline may be beneficial for the treatment of patients with sick sinus syndrome." 07/01/1997 - "Effects of permanent pacemaker and oral theophylline in sick sinus syndrome the THEOPACE study: a randomized controlled trial." 05/01/1995 - "This study suggests that the use of theophylline in patients with marked sinus node dysfunction may not decrease their risks for subsequent bradycardic events." 11/01/2023 - "While many case studies reported a resolution of symptoms, a randomized controlled trial reported no significant difference in symptom scores between the control, theophylline, and pacemaker groups in the treatment of sick sinus syndrome. " 09/30/2020 - "Pacemakers are more commonly recommended than theophylline for sick sinus syndrome (SSS) treatment. "
9.	PrenalterolIBA 01/01/1982 - "Electrophysiological studies with prenalterol in 19 patients (6 women, 13 men, 5 with sinus node disease, 4 with AV node disease, 7 with double node disease, 2 with conduction disturbance below His bundle, 1 normal) showed that sinus node function (heart rate, sinus node recovery time) is uniformly improved by this beta-stimulator. " 01/01/1985 - "Prenalterol in symptomatic sinus node dysfunction." 01/01/1983 - "In the 6 patients with sick sinus syndrome, prenalterol increased heart rate significantly and decreased maximum sinus node recovery time which reached a statistically significant value (P less than 0.05) 5 and 30 minutes after the second dose. " 10/01/1983 - "The electrophysiological effects of prenalterol, a new beta-receptor agonist, in a dose of 100 micrograms/kg body weight given intravenously for 5 min, were studied in 13 patients with signs of sinus node dysfunction and/or conduction defects within or distal to the atrioventricular (AV) node. " 08/01/1983 - "In the sick-sinus syndrome the pronounced chronotropic response to beta-adrenergic receptor stimulation with Prenalterol doses not indicate improvement of impaired sinus node function."
10.	pro-brain natriuretic peptide (1-76)IBA 10/08/2010 - "DDDR pacing results in left ventricular asynchrony with preservation of ejection fraction and NT-proBNP: a prospective study in sick sinus syndrome and normal ventricular function." 08/20/2017 - "We sought to investigate whether the CHA2DS2-VASc score predicts stroke and death in Chinese patients with sick sinus syndrome (SSS) after pacemaker implantation and to evaluate whether the predictive power of the CHA2DS2-VASc score could be improved by combining it with left atrial diameter (LAD) and amino-terminal pro-brain natriuretic peptide (NT-proBNP). " 08/20/2017 - "Value of Combining Left Atrial Diameter and Amino-terminal Pro-brain Natriuretic Peptide to the CHA2DS2-VASc Score for Predicting Stroke and Death in Patients with Sick Sinus Syndrome after Pacemaker Implantation." 01/01/2008 - "To investigate the contribution of right ventricular apical pacing to the left ventricular negative remodeling, we measured the inter- and intraventricular mechanical dyssynchrony by echocardiography as well as plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level in 116 consecutive patients of symptomatic bradyarrhythmias including sinus node dysfunction (SND) in 80 and atrioventricular block in 36. " 07/24/2009 - "To investigate the effect of bradyarrhythmia on the plasma levels of NT-proBNP, patients without defined ventricular diseases were enrolled in this study: group A, 42 patients without arrhythmia; group B, 43 patients with sick sinus syndrome; group C, 22 patients with II degrees atrioventricular block (AVB); group D, 35 patients with III degrees AVB and group E, 35 patients with persistent atrial fibrillation. "

Therapies and Procedures

1.	Therapeutics 11/01/2011 - "Selective PV isolation therefore appears to be an effective therapy to both achieve the successful treatment of AF and to prevent the manifestation of sick sinus syndrome." 11/01/2023 - "Overall, methylxanthines proved safe and effective as a pharmacologic therapy for bradyarrhythmic manifestations of sinus node dysfunction." 01/01/2022 - "Population aging has led to increased sick sinus syndrome (SSS) incidence; however, no effective and safe medical therapy has been reported thus far. " 01/01/1985 - "Atrial pacing appears to be a safe and effective therapy for children with sick sinus syndrome." 05/15/2005 - "Several large clinical studies have investigated the efficacy of treatment in conventional indications, so the role of pacemaker therapy in carotid sinus hyperaesthesia or sinus node disease has been elucidated. "
2.	Catheter Ablation 12/01/2014 - "In spite of a longer procedure time and risk of transient sinus node dysfunction, an SVC-L in addition to CPVI improved the clinical outcome of catheter ablation, and was associated with post-procedural autonomic neural remodelling in patients with PAF." 01/01/2023 - "Once validated invasively, this may have clinical implications in predicting risk of sinus node dysfunction and atrial arrhythmias, or in guiding catheter ablation." 06/04/2022 - "Identification of sinus node dysfunction (SND) before termination of persistent AFL by catheter ablation (CA) is challenging. " 01/01/2022 - "PPM implantation was lowest among those who had catheter ablation within 5 years of sick sinus syndrome diagnosis: group 1 versus group 2 (18.15% versus 27.21%) and group 1 versus group 3 (18.15% versus 27.22%). " 01/01/2022 - "Association between catheter ablation of AF timing and need for PPM in sick sinus syndrome has not been assessed. "
3.	Fontan Procedure (Fontan Operation) 06/01/2007 - "Use of ECC for modified Fontan operation reduces the risk of sinus node dysfunction and shows better outcome of immediate postoperative hemodynamics." 05/01/2003 - "This study compares the effects of two techniques for the Fontan procedure-intraatrial lateral tunnel (IALT) and extracardiac conduit (ECC) -on sinus node dysfunction. " 11/10/1998 - "This study sought to determine the early and late incidences of sinus node dysfunction in patients systematically and uniformly staged to a Fontan operation after a prior hemi-Fontan. " 11/10/1998 - "Although there is concern that an intermediate cavopulmonary connection may increase the risk of sinus node dysfunction, previous studies have not reported on patients routinely staged to a Fontan operation. " 01/01/1992 - "Histopathologic abnormalities of the sinus node compared with electrocardiographic evidence of sinus node dysfunction after the modified Fontan operation: an autopsy study of 14 cases."
4.	Massage (Zone Therapy) 02/01/2001 - "[Deciding about pacing mode in sinus node dysfunction: should carotid sinus massage be performed and in which circumstances?]." 10/01/1993 - "The different percentage of positive findings on head-up tilt testing and carotid sinus massage in the two groups was independent of the presence of intrinsic sinus node dysfunction. " 11/05/1977 - "We conclude that in 1/4 to 1/3 of these elderly people the sinus node reacts in a hypersensitive manner to carotid sinus massage, but this does not imply the diagnosis of sick sinus syndrome." 08/01/1985 - "These findings were: His-Purkinje disease in 49 patients (30%), inducible ventricular arrhythmias in 36 (22%), AV nodal disease in 20 (12%), sinus node disease in 19 (12%), inducible supraventricular arrhythmias in 18 (11%), carotid sinus hypersensitivity (not elicited by carotid sinus massage prior to electrophysiologic studies) in 15 (9%), and hypervagotonia in five (3%). " 06/01/1984 - "This study was undertaken to establish the nature (intrinsic or extrinsic) of sinus node dysfunction in patients presenting with syncope and abnormal response (sinus pause greater than 3'') to vagal manoeuvres (carotid sinus massage and/or eye-ball compression). "
5.	Drug Therapy (Chemotherapy) 03/01/1987 - "[Clinical study on the efficacy of drug therapy in sick sinus node syndrome]." 01/01/1976 - "[Drug therapy and permanent endocardial stimulation in sick sinus syndrome: a study of 75 cases]." 01/01/2021 - "Electrocardiography performed before initiating chemotherapy showed sinus arrest for about 4 s, and Holter electrocardiography showed sinus arrest for up to about 7.4 s, which was repeatedly observed 6 times, indicating sick sinus syndrome (SSS). " 01/01/1981 - "In 74 symptomatic patients suffering from sick sinus syndrome, survival after pacemaker implantation and additional drug therapy was determined. " 04/01/2022 - "This case report describes the successful treatment of sick sinus syndrome in an 84-year-old man with cardiac lymphoma via chemotherapy without pacemaker implantation."