Permanent His-bundle pacing in the right atrium in a patient with a Mobitz II atrioventricular block: a case presentation

Background This case report presents a patient diagnosed with sick sinus syndrome who was successfully treated with permanent His-bundle pacing (PHBP). Case presentation A 36-year-old man was transferred to our hospital due to recurrent syncope. He was diagnosed with sick sinus syndrome based on the 24-h Holter and a history of syncope. He was admitted to hospital and successfully treated with PHBP. The postoperative examination showed that the pacing rhythm, pacemaker pacing and perception function were normal. He was discharged without any complications after a successful pacemaker implantation. Conclusions We described a case in which PHBP may become an optimal approach to the management of patients with sick sinus syndrome. Right ventricular pacing has been attempted with inconsistent efficacy outcomes. HBP provides a promising alternative pacing option that might provide symptom resolution to patients with sick sinus syndrome.

Relationship of NT-ProBNP and pacemaker parameters in patients with sick sinus syndrome?

Objectives: NT-ProBNP could influence the pacemaker parameters in patients with sick sisnus syndrome? Methods and Results: 93 patients with sick sinus syndrome were implanted 2 chambers pacemaker with mean aged 61,19±14,95 years old and 37,6% of male. The pacemaker parameters of ventricular lead include: Pacing thresholds were measured 0.75 ± 0.17 V, sensing amplitudes were measured 9,93 ± 4.01 mV, and lead impedances were measured 710,06 ± 130,86 ᾨ. The pacemaker parameters of atrial lead include: Pacing thresholds were measured 1,06 ± 0,29 V, sensing amplitudes were measured 2,58 ± 1,23 mV, and lead impedances were measured 509,13 ± 69,22 ᾨ. There is not significantly relationships of NT-ProBNP and pacemaker parameters of ventricular lead, atrial lead impedance, atrial lead sensing amplitudes (p>0,05). However, there is significantly relationship of NT-ProBNP and atrial lead pacing threshold (r=0,34; p=0,003). Conclusion: There is significantly relationship of NT proBNP and atrial lead pacing threshold in patients with sick sinus syndrome who were implanted the pacemaker.

Clinical Spectrum of SCN5A Channelopathy in Children with Primary Electrical Disease and Structurally Normal Hearts

Sodium voltage-gated channel α subunit 5 (SCN5A)-mutations may cause an array of arrhythmogenic syndromes most frequently as an autosomal dominant trait, with incomplete penetrance, variable expressivity and male predominance. In the present study, we retrospectively describe a group of Mexican patients with SCN5A-disease causing variants in whom the onset of symptoms occurred in the pediatric age range. The study included 17 patients with clinical diagnosis of primary electrical disease, at least one SCN5A pathogenic or likely pathogenic mutation and age of onset <18 years, and all available first- and second-degree relatives. Fifteen patients (88.2%) were male, and sixteen independent variants were found (twelve missense, three truncating and one complex inframe deletion/insertion). The frequency of compound heterozygosity was remarkably high (3/17, 17.6%), with early childhood onset and severe disease. Overall, 70.6% of pediatric patients presented with overlap syndrome, 11.8% with isolated sick sinus syndrome, 11.8% with isolated Brugada syndrome (BrS) and 5.9% with isolated type 3 long QT syndrome (LQTS). A total of 24/45 SCN5A mutation carriers were affected (overall penetrance 53.3%), and penetrance was higher in males (63.3%, 19 affected/30 mutation carriers) than in females (33.3%, 5 affected/15 carriers). In conclusion, pediatric patients with SCNA-disease causing variants presented mainly as overlap syndrome, with predominant loss-of-function phenotypes of sick sinus syndrome (SSS), progressive cardiac conduction disease (PCCD) and ventricular arrhythmias.

Inherited and Acquired Rhythm Disturbances in Sick Sinus Syndrome, Brugada Syndrome, and Atrial Fibrillation: Lessons from Preclinical Modeling

Rhythm disturbances are life-threatening cardiovascular diseases, accounting for many deaths annually worldwide. Abnormal electrical activity might arise in a structurally normal heart in response to specific triggers or as a consequence of cardiac tissue alterations, in both cases with catastrophic consequences on heart global functioning. Preclinical modeling by recapitulating human pathophysiology of rhythm disturbances is fundamental to increase the comprehension of these diseases and propose effective strategies for their prevention, diagnosis, and clinical management. In silico, in vivo, and in vitro models found variable application to dissect many congenital and acquired rhythm disturbances. In the copious list of rhythm disturbances, diseases of the conduction system, as sick sinus syndrome, Brugada syndrome, and atrial fibrillation, have found extensive preclinical modeling. In addition, the electrical remodeling as a result of other cardiovascular diseases has also been investigated in models of hypertrophic cardiomyopathy, cardiac fibrosis, as well as arrhythmias induced by other non-cardiac pathologies, stress, and drug cardiotoxicity. This review aims to offer a critical overview on the effective ability of in silico bioinformatic tools, in vivo animal studies, in vitro models to provide insights on human heart rhythm pathophysiology in case of sick sinus syndrome, Brugada syndrome, and atrial fibrillation and advance their safe and successful translation into the cardiology arena.

Rare health conditions 52: sick sinus syndrome, Saturday Night Fever, empowerment and engaging with local communities

The purpose of this series is to briefly highlight a range of rare health conditions. Rare health conditions are those that affect no more and usually fewer than 1 person in every 2000. Many healthcare assistants and nurses will encounter some of these conditions, given the high number of them. This 52nd article will explore two of these conditions, sick sinus syndrome and Saturday Night Fever, with a short discussion on empowering people.

A Famous Chinese Prescription That Promotes Hcn4 Activity in Bone Marrow Mesenchymal Stem Cells is Shenfu Injection: Opinion

Sick Sinus Syndrome (SSS) refers to a group of heart rhythm disorders caused by problems relating to the sinus node. Currently, there is no effective treatment for SSS, and an electronic pacemaker is required to support heart function in SSS patients. However, electronic pacemakers are associated with several defects. For example, external magnetic noise commonly interferes, leading to complications. In addition, some patients, especially children with congenitals inoatrial node dysfunction, are not suitable subjects for pacemaker insertion. Therefore, the search for new therapeutic strategies for treating cardiovascular diseases has become imperative. Shenfu injection (SFI), a Chinese herbal medicine, is effective in improving bradyarrhythmia. However, the underlying mechanism of SFI's therapeutic effect remains elusive.