Sick sinus syndrome
Synonyms in the broadest sense
Sinus node syndrome, bradycardiac arrhythmia,
Bradycardia-Tachycardia Syndrome
definition
Of the Sinus node is not able to evoke potentials in a sufficient frequency and / or to the AV node forward.
Cause: In the case of a sinus node disease, there is either a malfunction of the pacemaker cells or a blockage of the conduction system, so that the electrical potentials do not reach the AV node.
Symptoms
The symptoms are similar to those of the 2nd and 3rd degree AV block.
Find the symptoms here: AV block
causes
The sick sinus syndrome mainly affects elderly patients and is due to organic heart disease in only a part of the cases. Often times, the use of certain drugs that slow the heartbeat is a potentially reversible cause. Such drugs would be e.g. Digitalis preparations that are often used for heart failure (heart failure) or antiarrhythmics. However, other substances can also be used.
Bradycardia-Tachycardia Syndrome
Bradycardia-tachycardia syndrome is a special form of sinus node syndrome.
Synonym: Paroxymal supraventricular tachycardia.
At this point it makes sense to also deal with the main page on bradycardia: What is bradycardia?
definition
After the occurrence of the tachycardia (pathologically fast pulse) there is an asystolic pause (no heartbeat) until the bradycardic sinus rhythm (slow heartbeat) starts again. So it's actually a constant change between a rhythm that is too fast and too slow.
Note: Bradycardia-Tachycardia Syndrome
Bradycardia-tachycardia syndrome is more common in young people.
Symptoms
In the tachycardiac phases: palpitations, dyspnoea (shortness of breath), Angina pectoris (Feeling of tightness in the heart)
In the bradykarden (slow) phases: dizziness, syncope (fainting spells) and Adam Stokes Seizures (so.)
diagnosis
That becomes a diagnosis Long-term ECG used. In addition to recording the lowered heart rate, it also serves to quantify the disturbance, i.e. to estimate the extent of the arrhythmia.
Also using the Exercise ECG the diagnosis can be made. There it is shown that with the ergometer load there is an inability to achieve over 70% of the age-appropriate frequency increase.
Figure sinus node
- Sinus node -
Nodus sinuatrialis - AV node -
Nodus atrioventricularis - Trunk of the excitation conduction
systems -
Atrioventricular fasciculus - Right thigh -
Crus dextrum - Left leg -
Crus sinistrum - Rear thigh branch -
R. cruris sinistri posterior - Front thigh branch -
R. cruris sinistri anterior - Purkinje fibers -
Subendocardiales - Right atrial -
Atrium dextrum - Right ventricle -
Ventriculus dexter
You can find an overview of all Dr-Gumpert images at: medical illustrations
therapy
Therapy for sick sinus syndrome is only necessary if there are symptoms of bradycardia (very slow heartbeat) such as Adam Stokes (fainting) fits.
If so, the method of choice is one Pacemaker therapy. Systems that are involved in the atrium (AAI, DDD) are mainly used. Is there any suspicion that ingested Medication are responsible for slowing down the frequency, they should be stopped first.
When tachycardia bradycardia syndrome come in addition to pacemaker therapy antiarrhythmic drugs for use.
forecast
The prognosis is good. If drugs are the cause of the disease, life expectancy is not reduced. Otherwise, the underlying disease that triggers it determines life expectancy.
