Sinoatrial block: Difference between revisions
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{{SK}}; SA nodal exit block; exit block; Sino atrial exit block; Sinoatrial nodal block | {{SK}}; SA nodal exit block; exit block; Sino atrial exit block; Sinoatrial nodal block; sino-auricular block | ||
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==Overview== | ==Overview== | ||
Sinoatrial block is an uncommon dysrhythmia of unknown mechanism, characterized by the omission of P waves in the setting of a basic regular rhythm. It is found incidentally in normal asymptomatic subjects and in some having pre syncope or syncope. It may occur as an isolated dysrhythmia or in association with sinus bradycardia, tachycardia or, sometimes, with atrioventricular conduction disorders. | Sinoatrial block is an uncommon dysrhythmia of unknown mechanism, characterized by the omission of P waves in the setting of a basic regular rhythm. It is found incidentally in normal asymptomatic subjects and in some having pre syncope or syncope. It may occur as an isolated dysrhythmia or in association with sinus bradycardia, tachycardia or, sometimes, with atrioventricular conduction disorders. | ||
Revision as of 21:13, 29 August 2013
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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:; SA nodal exit block; exit block; Sino atrial exit block; Sinoatrial nodal block; sino-auricular block
block.
Overview
Sinoatrial block is an uncommon dysrhythmia of unknown mechanism, characterized by the omission of P waves in the setting of a basic regular rhythm. It is found incidentally in normal asymptomatic subjects and in some having pre syncope or syncope. It may occur as an isolated dysrhythmia or in association with sinus bradycardia, tachycardia or, sometimes, with atrioventricular conduction disorders. [1]
Classification
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Acute coronary syndrome
- Acute renal failure
- Diabetic ketoacidosis
- Lateral medullary syndrome
- Myocardial rupture
- NSTEMI
- Organophosphate poisoning
- Parathion poisoning
- Poisonous spider bites
- Septic shock
- Severe brain injury
- STEMI
Common Causes
- Acetylcholine
- Acute coronary syndrome
- Amiodarone
- Beta blockers
- Calcium channel blockers
- Digoxin
- Dilated cardiomyopathy
- Hyperkalemia
- Hypermagnesemia
- Hypertrophic cardiomyopathy
- Myocarditis
- Pericarditis
- Sick sinus syndrome
- Sinus node fibrosis
- STEMI
Causes by Organ System
Causes in Alphabetical Order
Differentiating Sinoatrial block from other Diseases
Other types of SA nodal dysfunction are discussed in detail in other chapters on wikidoc. Follow the hyperlinks for details and those include:
Diagnosis
Treatment
Sinoatrial block principles of treatment are the same as sinus pause or sick sinus syndrome. Usually no treatment is indicated if the patient is asymptomatic. Stopping the offending drug is generally reasonable. When symptoms occur and become intolerable or life-threatening, then a permanent pacemaker would be indicated.
References
- ↑ GREENWOOD RJ, FINKELSTEIN D, MONHEIT R (1961). "Sinoatrial heart block with Wenckebach phenomenon". Am J Cardiol. 8: 140–6. PMID 13708372.
- ↑ Bailey PL (1990). "Sinus arrest induced by trivial nasal stimulation during alfentanil-nitrous oxide anaesthesia". Br J Anaesth. 65 (5): 718–20. PMID 2248851.
- ↑ 3.0 3.1 3.2 Mills TA, Kawji MM, Cataldo VD, Pappas ND, O'Meallie LP, Breaux DM; et al. (2004). "Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs". J La State Med Soc. 156 (6): 327–31. PMID 15688675.
- ↑ 4.0 4.1 Lines D, Shipton EA (1991). "Severe bradycardia and sinus arrest after administration of vecuronium, fentanyl and halothane. A case report". S Afr Med J. 80 (4): 200–1. PMID 1678901.
- ↑ Bonvini RF, Hendiri T, Anwar A (2006). "Sinus arrest and moderate hyperkalemia". Annales De Cardiologie Et D'angéiologie. 55 (3): 161–3. PMID 16792034. Unknown parameter
|month=ignored (help) - ↑ Koay S, Dewan B (2013). "An unexpected Holter monitor result: multiple sinus arrests in a patient with lateral medullary syndrome". BMJ Case Rep. 2013. doi:10.1136/bcr-2012-007783. PMID 23386489.