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:

Networked: 698 relevant articles (22 outcomes, 65 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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

Experts

1.	Mohler, Peter J: 10 articles (07/2014 - 05/2005)
2.	Hund, Thomas J: 9 articles (07/2014 - 10/2008)
3.	Anderson, Mark E: 6 articles (08/2014 - 10/2008)
4.	Wilde, Arthur A M: 6 articles (01/2013 - 05/2003)
5.	Lei, Ming: 6 articles (01/2013 - 09/2005)
6.	Boriani, Giuseppe: 5 articles (08/2008 - 07/2005)
7.	Huang, Christopher L-H: 4 articles (01/2013 - 09/2005)
8.	Gulizia, Michele: 4 articles (01/2008 - 07/2005)
9.	Grammatico, Andrea: 4 articles (01/2008 - 07/2005)
10.	Makita, Naomasa: 3 articles (04/2015 - 05/2009)

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. " 01/01/2015 - "The study enrolled 50 consecutive patients with prolonged PQ interval who were implanted with DDD pacemaker because of sinus node disease. "
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.	Atropine (Hyoscyamine)FDA LinkGeneric 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]." 01/01/1979 - "[A reevaluation of the clinical significance of atropine test in the diagnosis of sick sinus syndrome (author's transl)]."
4.	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."
5.	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). "
6.	Amiodarone (Amiodarona)FDA LinkGeneric 08/01/1987 - "Effect of amiodarone on sinus node function in patients with sick sinus syndrome." 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. " 12/01/2010 - "Amiodarone however caused sinus node dysfunction and temporary electrode pacing had to be used. " 04/01/2006 - "Design and rationale of a randomized study to compare amiodarone and Class IC anti-arrhythmic drugs in terms of atrial fibrillation treatment efficacy in patients paced for sinus node disease: the PITAGORA trial." 11/01/2000 - "Sinus node disease was present in one patient after ICV, and two patients developed amiodarone-induced hyperthyroidism. "
7.	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." 12/01/1997 - "Oral theophylline may play a role in the treatment of sinus node disease." 07/01/1997 - "Pacemakers and theophylline are currently being used to relieve symptoms in patients with sick sinus syndrome (SSS). "
8.	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 - "The electrophysiological effects of intravenous administration of disopyramide (1.5 mg/kg) were studied in 26 patients with sinus node dysfunction (SND). " 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. " 06/01/2005 - "Atrial pacing failure occurred after termination of atrial fibrillation by acute administration of disopyramide phosphate in a 71-year-old woman implanted with an AAI pacemaker for sick sinus syndrome. "
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." 08/01/1983 - "[Beta-adrenergic stimulation with prenalterol in sick sinus syndrome]." 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. "
10.	Carbamazepine (Tegretol)FDA LinkGeneric 06/01/1986 - "ECG monitoring confirmed a severe sick sinus syndrome which improved on carbamazepine withdrawal. " 03/01/1997 - "Carbamazepine-induced sinus node dysfunction." 07/01/1998 - "We report on four elderly women in whom carbamazepine was suspected of inducing sinus node dysfunction (3 patients) and atrioventricular block (1 patient). " 07/01/1998 - "Carbamazepine-induced sinus node dysfunction and atrioventricular block in elderly women." 06/01/1986 - "A case of sick sinus syndrome aggravated by carbamazepine prescribed for epilepsy is described. "

Therapies and Procedures

1.	Transplantation (Transplant Recipients) 12/01/1997 - "The need for permanent pacemaker implantation due to sinus node dysfunction after transplantation was completely eliminated with this new technique. " 09/01/1998 - "The purpose of this study was to compare clinical and hemodynamic data of heart transplant recipients with acquired sinus node disease treated with atrial synchronized pacing and patients with other pacing modes or without pacemakers 1 year after operation. " 09/01/2008 - "Pacemaker therapy for early and late sinus node dysfunction in orthotopic heart transplant recipients: a single-center experience." 01/01/2000 - "Sinus node dysfunction was the principal indication for temporary and permanent pacemaker implantation in cardiac transplant recipients. " 09/01/1998 - "It is concluded that electromechanical synchronization of the atria was of long-term benefit in heart transplant recipients with recipient sinus rhythm and donor sinus node disease."
2.	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. " 09/01/2014 - "The two options for pacemaker implantation for sinus node dysfunction after the Fontan operation are epicardial lead placement, which allows for dual-chamber pacing, or transvenous atrial pacing. "
3.	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]." 01/01/1994 - "Major problems during long-term antiarrhythmic drug therapy may arise in patients with pre-existing sinus node dysfunction or conduction disturbances of the atrioventricular node. " 01/01/1981 - "In 74 symptomatic patients suffering from sick sinus syndrome, survival after pacemaker implantation and additional drug therapy was determined. " 01/01/2003 - "We report the course of therapy for an 87-year-old with symptomatic sinus node dysfunction and paroxysmal atrial fibrillation who was intolerant of drug therapy. "
4.	Massage (Reflexology) 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.	Aftercare (After-Treatment) 09/01/1990 - "The major symptoms of sick sinus syndrome was greatly improved after treatment. " 02/01/2007 - "[Regression of sick sinus syndrome after treatment of sleep apnea syndrome]."