Sick sinus syndrome: Difference between revisions

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(/* ACC / AHA Guidelines- Recommendations for Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT) Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby ...)
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Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy. However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.
Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy. However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.
==ACC / AHA Guidelines- Recommendations for Permanent Pacing in Sinus Node Dysfunction (DO NOT EDIT) <ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>==
{{cquote| 
===Class I===
1. Permanent [[pacemaker]] implantation is indicated for [[SND]] with documented symptomatic [[bradycardia]], including frequent sinus pauses that produce symptoms. ''(Level of Evidence: C)''
2. Permanent [[pacemaker]] implantation is indicated for symptomatic chronotropic incompetence. ''(Level of Evidence: C)''
3. Permanent [[pacemaker]] implantation is indicated for symptomatic [[sinus bradycardia]] that results from required drug therapy for medical conditions. ''(Level of Evidence: C)''
===Class IIa===
1. Permanent [[pacemaker]] implantation is reasonable for [[SND]] with heart rate less than 40 bpm when a clear association between significant symptoms consistent with [[bradycardia]] and the actual presence of [[bradycardia]] has not been documented. ''(Level of Evidence: C)''
2. Permanent [[pacemaker]] implantation is reasonable for [[syncope]] of unexplained origin when clinically significant abnormalities of [[sinus node]] function are discovered or provoked in electrophysiological studies. ''(Level of Evidence: C)''
===Class IIb===
1. Permanent [[pacemaker]] implantation may be considered in minimally symptomatic patients with chronic heart rate less than 40 bpm while awake. ''(Level of Evidence: C)''
===Class III===
1. Permanent [[pacemaker]] implantation is not indicated for [[SND]] in asymptomatic patients. ''(Level of Evidence: C)''
2. Permanent [[pacemaker]] implantation is not indicated for [[SND]] in patients for whom the symptoms suggestive of [[bradycardia]] have been clearly documented to occur in the absence of [[bradycardia]]. ''(Level of Evidence: C)''
3. Permanent [[pacemaker]] implantation is not indicated for [[SND]] with symptomatic [[bradycardia]] due to nonessential drug therapy. ''(Level of Evidence: C)''}}


==External links==
==External links==

Revision as of 04:03, 28 August 2012

Sick sinus syndrome
Sick sinus syndrome
ICD-10 I49.5
ICD-9 427.81
OMIM 163800
DiseasesDB 12066

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Bradycardia-tachycardia syndrome, tachycardia-bradycardia syndrome, tachy-brady syndrome, sinus node dysfunction, SND, SSS. Sinus arrest, sinus bradycardia, are forms or variants of sick sinus syndrome.

Treatment

Bradyarrhythmias are well controlled with pacemakers, while tachyarrhythmias respond well to medical therapy. However, because both bradyarrhythmias and tachyarrhythmias may be present, drugs to control tachyarrhythmia may exacerbate bradyarrhythmia. Therefore, a pacemaker is implanted before drug therapy is begun for the tachyarrhythmia.

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References

  • Adan V, Crown LA (2003). "Diagnosis and treatment of sick sinus syndrome". Am Fam Physician. 67 (8): 1725–32. PMID 12725451.

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