Sick sinus syndrome electrocardiogram: Difference between revisions
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Sick sinus syndrome is a collection of heart rhythm disorders that include [[sinus bradycardia]], sinus pauses and [[sinus arrest]]. Sick sinus syndrome can evolve towards causing [[atrial fibrillation]], [[atrial flutter]], ectopic [[atrial tachycardia]], sinus node reentrant tachycardia, and [[tachycardia-bradycardia]]. | Sick sinus syndrome is a collection of heart rhythm disorders that include [[sinus bradycardia]], sinus pauses and [[sinus arrest]]. Sick sinus syndrome can evolve towards causing [[atrial fibrillation]], [[atrial flutter]], ectopic [[atrial tachycardia]], sinus node reentrant tachycardia, and [[tachycardia-bradycardia]]. | ||
==Electrocardiogram== | ==Electrocardiogram== | ||
Ambulatory monitoring of the [[electrocardiogram]] (EKG) may be necessary because arrhythmias are transient. The EKG may show any of the following:<ref name="RubensteinSchulman1972">{{cite journal|last1=Rubenstein|first1=Joel J.|last2=Schulman|first2=Charles L.|last3=Yurchak|first3=Peter M.|last4=Desanctis|first4=Roman W.|title=Clinical Spectrum of the Sick Sinus Syndrome|journal=Circulation|volume=46|issue=1|year=1972|pages=5–13|issn=0009-7322|doi=10.1161/01.CIR.46.1.5}}</ref> | Ambulatory monitoring of the [[electrocardiogram]] (EKG) may be necessary because arrhythmias are transient. The EKG may show any of the following:<ref name="RubensteinSchulman1972">{{cite journal|last1=Rubenstein|first1=Joel J.|last2=Schulman|first2=Charles L.|last3=Yurchak|first3=Peter M.|last4=Desanctis|first4=Roman W.|title=Clinical Spectrum of the Sick Sinus Syndrome|journal=Circulation|volume=46|issue=1|year=1972|pages=5–13|issn=0009-7322|doi=10.1161/01.CIR.46.1.5}}</ref><ref name="ParkCho2004">{{cite journal|last1=Park|first1=Hyung Wook|last2=Cho|first2=Jeong Gwan|last3=Yum|first3=Ju Hyup|last4=Hong|first4=Young Joon|last5=Lim|first5=Ji Hyun|last6=Kim|first6=Han Gyun|last7=Kim|first7=Ju Han|last8=Kim|first8=Weon|last9=Ahn|first9=Young Keun|last10=Jeong|first10=Myung Ho|last11=Park|first11=Jong Chun|last12=Kang|first12=Jung Chaee|title=Clinical Characteristics of Hypervagotonic Sinus Node Dysfunction|journal=The Korean Journal of Internal Medicine|volume=19|issue=3|year=2004|pages=155–159|issn=1226-3303|doi=10.3904/kjim.2004.19.3.155}}</ref> | ||
* Inappropriate [[sinus bradycardia]] | * Inappropriate [[sinus bradycardia]] | ||
* [[Sinus arrest]] | * [[Sinus arrest]] | ||
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* Ectopic atrial tachycardia | * Ectopic atrial tachycardia | ||
* Sinus node reentrant tachycardia | * Sinus node reentrant tachycardia | ||
* [[Tachycardia-bradycardia]] | |||
Electrophysiologic tests are no longer used for diagnostic purposes because of their low specificity and sensitivity. Cardioinhibitory and vasodepressor forms of sick sinus syndrome may be revealed by [[tilt table test]]ing. | Electrophysiologic tests are no longer used for diagnostic purposes because of their low specificity and sensitivity. Cardioinhibitory and vasodepressor forms of sick sinus syndrome may be revealed by [[tilt table test]]ing. | ||
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Revision as of 01:59, 7 April 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Sick sinus syndrome is a collection of heart rhythm disorders that include sinus bradycardia, sinus pauses and sinus arrest. Sick sinus syndrome can evolve towards causing atrial fibrillation, atrial flutter, ectopic atrial tachycardia, sinus node reentrant tachycardia, and tachycardia-bradycardia.
Electrocardiogram
Ambulatory monitoring of the electrocardiogram (EKG) may be necessary because arrhythmias are transient. The EKG may show any of the following:[1][2]
- Inappropriate sinus bradycardia
- Sinus arrest
- Sinoatrial block
- Atrial fibrillation with slow ventricular response
- A prolonged asystolic period after a period of tachycardias
- Atrial flutter
- Ectopic atrial tachycardia
- Sinus node reentrant tachycardia
- Tachycardia-bradycardia
Electrophysiologic tests are no longer used for diagnostic purposes because of their low specificity and sensitivity. Cardioinhibitory and vasodepressor forms of sick sinus syndrome may be revealed by tilt table testing.
Shown below is an EKG demonstrating sick sinus syndrome. Atrial fibrillation is present (an irregularly irregular rhythm) which stops abruptly due to sinus arrest.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
Shown below is an EKG showing the termination of a supraventricular tachycardia at about 130/min. which terminates and leaves a pause and then sinus bradycardia. This is a from of "tachy/brady" syndrome where a tachycardia is followed by a bradycardia.
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
- For more EKG examples of sick sinus syndrome click here.
References
- ↑ Rubenstein, Joel J.; Schulman, Charles L.; Yurchak, Peter M.; Desanctis, Roman W. (1972). "Clinical Spectrum of the Sick Sinus Syndrome". Circulation. 46 (1): 5–13. doi:10.1161/01.CIR.46.1.5. ISSN 0009-7322.
- ↑ Park, Hyung Wook; Cho, Jeong Gwan; Yum, Ju Hyup; Hong, Young Joon; Lim, Ji Hyun; Kim, Han Gyun; Kim, Ju Han; Kim, Weon; Ahn, Young Keun; Jeong, Myung Ho; Park, Jong Chun; Kang, Jung Chaee (2004). "Clinical Characteristics of Hypervagotonic Sinus Node Dysfunction". The Korean Journal of Internal Medicine. 19 (3): 155–159. doi:10.3904/kjim.2004.19.3.155. ISSN 1226-3303.