Sinoatrial block

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]

Synonyms and keywords:

Overview

The sinoatrial (SA) node represents the original pacemaker of the heart. It's formed of cells, sometimes called P cells, in a compact region at the junction of the high right atrium and the superior vena cava. The surrounding cells or Perinodal cells, sometimes called (T) cells, transmit the electrical impulse from the SA node to the right atrium. Each of these cell types has distinct expression profiles of ion channels and gap junctions. SA nodal dysfunction typically results from either abnormalities in signal generation by the P cells or abnormalities in conduction across the T cells. Sinoatrial nodal dysfunction includes pauses, arrest, exit block and ultimately sick sinus syndrome. We will provide an algorithm to differentiate those subtypes later in this page.

Differentiating Sinoatrial block from other Diseases

Types of SA nodal dysfunction include:

• Sinus pause or arrest; This abnormality is an alteration in discharge by the SA pacemaker; as a result, the duration of the pause is variable and presents as a pause with no P waves on EKG.
• SA nodal exit block
• Sinus arrhythmia
• Wandering atrial pacemaker
• sick sinus syndrome

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