Case 89 Sinus bradycardia with sinus arrest leading to ventricular escape-bigeminy and atrial parasystole in a patient with SSS

2015 ◽  
pp. 181-182
Keyword(s):  
Sinus Bradycardia ◽  
Sinus Arrest

Some effects of breath holding and apneic underwater diving on cardiac rhythm in man

1962 ◽  
Vol 17 (3) ◽  
pp. 461-466 ◽  
Author(s):  
C. Robert Olsen ◽  
Darrell D. Fanestil ◽  
Per F. Scholander
Keyword(s):  
Cardiac Arrhythmias ◽  
Cardiac Rhythm ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Sinus Bradycardia ◽  
Breath Holding ◽  
Sinus Arrest ◽  
Sinus Arrhythmia ◽  
Normal Sinus ◽  
Idioventricular Rhythm

Man's bradycardic response to simple breath holding was augmented by submersion in water of 27 C and was not prevented by muscular exercise. Cardiac arrhythmias occurred with 45 of 64 periods of apnea in 16 subjects and were more frequent during the dives than during breath holding. These arrhythmias, with the exception of atrial, nodal, and ventricular premature contractions, were inhibitory in type and included sinus bradycardia and arrhythmia, sinus arrest followed by either nodal escape or ventricular escape, A-V block, A-V nodal rhythm, and idioventricular rhythm. T waves frequently became tall and peaked during both breath holding and dives. Prompt return to normal sinus rhythm was the rule with the first breath after surfacing. Sinus tachycardia, sinus arrhythmia, and atrial, nodal, or ventricular premature contractions were seen during recovery. Submitted on October 9, 1961

scholarly journals Pacemaker Implant in a Dog with Sick Sinus Syndrome

2017 ◽  
Vol 45 ◽  
pp. 6
Author(s):  
Amanda Sarita Cruz Aleixo ◽  
Angélica Alfonso ◽  
Bárbara Keiko Kichise ◽  
Francisco Teixeira Neto ◽  
Carolina Hagy Girotto ◽  
...  
Keyword(s):  
Physical Examination ◽  
Medical History ◽  
Sick Sinus Syndrome ◽  
Present Report ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Clinical Signs ◽  
Clinical Aspects ◽  
Cardiac Auscultation ◽  
Sinus Arrest

Background: Sick sinus syndrome is characterized by the presence of arrhythmias, including persistent sinus bradycardia, sinus arrest and paroxysmal atrial tachyarrhythmia. It commonly occurs in elderly dogs, especially miniature schnauzers; however, it is also detected in dachshunds and pugs. Reports of clinical signs by animal owners are not always clear and precise, which may result in erroneous interpretations by veterinarians; consequently, the use of inappropriate therapies. The present work aims to describe clinical aspects and findings from tests related to sick sinus syndrome (SSS) and presents the case of a female schnauzer with SSS.Case: A 10-year-old female dog (schnauzer, 8.6 kg) attended the Veterinary Hospital of the FMVZ-UNESP - Botucatu. The owner mentioned convulsive episodes, but a thorough medical history and patient assessment revealed that the dog exhibited episodes of syncope. During the physical examination, cardiac auscultation revealed the heart rate to be 56 beats per minute (bpm), and there was a presence of pauses. Also during cardiac auscultation, a holosystolic heart murmur was verified, with a focus on the mitral and tricuspid valves. The electrocardiogram showed the presence of sinus arrest with escape rhythms, pauses of 10 s and the presence of bradycardia-tachycardia syndrome. A Holter monitor was used to establish the diagnosis of SSS. The patient presented with significant episodes of syncope during outpatient care, and based on the clinical manifestation, drug therapy was initiated. The prescribed medications were aminophylline 20 mg/ kg TID, enalapril maleate 0.5 mg/kg BID, spironolactone 1 mg/kg SID and furosemide 2 mg/kg BID. After the start of treatment, there was a reduction in the frequency of episodes of syncope. Three weeks after diagnosis, a pacemaker device was implanted. Currently, clinical signs are absent.Discussion: Sinus node dysfunction is one of the main reasons for pacemaker implantation. It is usually diagnosed based on clinical signs and the presence of sinus bradycardia and sinus pauses in electrocardiograms or Holter monitoring. The diagnosis of SSS is limited to cases in which the patient does not present with abnormalities in an electrocardiogram. Syncope is a clinical sign commonly present in patients with dysfunction of the sinus node, and episodes of syncope were reported by the owner of the dog referred to in the present report. A thorough medical history and physical examination must be performed to diagnose SSS because erroneous diagnosis and incorrect interpretations of clinical signs can lead to the misuse of medications. The treatment of choice for SSS is an implantable pacemaker device; however, because the method is not widely used in Brazil, a second option is drug treatment. In the present report, after implantation of a pacemaker, clinical signs ceased, and the patient was in good general health and could return to her normal activities. Sick sinus syndrome is a disease commonly found in schnauzers. There is a need for detailed histories and complementary exams because the clinical signs do not always correlate with electrocardiographic findings. The implantation of a pacemaker is the treatment of choice and is effective for the condition, but its use is not uniformly accessible throughout the country.

Persistent Fetal Sinus Bradycardia Associated with Maternal Anti-SSA/Ro and Anti-SSB/La Antibodies

2011 ◽  
Vol 38 (12) ◽  
pp. 2682-2685 ◽  
Author(s):  
PRIYA CHOCKALINGAM ◽  
EDGAR T. JAEGGI ◽  
LUKAS A. RAMMELOO ◽  
MONIQUE C. HAAK ◽  
PHEBE N. ADAMA van SCHELTEMA ◽  
...  
Keyword(s):  
Heart Block ◽  
Cardiac Involvement ◽  
Clinical Course ◽  
Complete Heart Block ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Good Prognosis ◽  
Sinus Arrest ◽  
Congenital Complete Heart Block ◽  
Myocardial Involvement

Objective.To study the clinical course and outcome of fetal sinus bradycardia (SB) due to maternal antibody-induced sinus node dysfunction.Methods.We reviewed the maternal, prenatal, and postnatal findings of fetuses with SB associated with elevated maternal anti-SSA/Ro and anti-SSB/La antibodies.Results.Of the 6 cases diagnosed prenatally, 3 had isolated SB persisting after birth and had a good prognosis. Three fetuses with SB and severe myocardial involvement (congenital complete heart block and/or endocardial fibroelastosis) succumbed in utero in spite of treatment. Postmortem histopathology in 1 fetus showed inflammatory destruction of the sinus and atrioventricular nodes. SB was detected incidentally in a 7-year-old girl. She had intermittent heart block with progressive sinus arrest requiring permanent pacemaker.Conclusion.Fetal SB associated with maternal autoantibodies may persist in childhood, with a good prognosis in the absence of widespread cardiac involvement.

Classification of bradyarrhythmias

ESC CardioMed ◽  
2018 ◽  
pp. 1931-1935
Author(s):  
Bulent Gorenek ◽  
Gulmira Kudaiberdieva
Keyword(s):  
Clinical Presentation ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Sinus Arrest ◽  
Chronotropic Incompetence

This chapter presents the classification of bradyarrhythmias by electrocardiography, electrophysiological and anatomical levels of blocks, clinical presentation, and aetiology. Sinus node dysfunction, including sinus bradycardia, sinus pause and sinus arrest, sinoatrial blocks, chronotropic incompetence, and bradycardia–tachycardia syndrome, and atrioventricular blocks are discussed. A comprehensive aetiology of bradyarrhythmias is presented, including congenital, acquired, and iatrogenic causes.

scholarly journals Sinus bradycardia and multiple episodes of sinus arrest following administration of ibutilide

Heart ◽  
1998 ◽  
Vol 79 (6) ◽  
pp. 628-629 ◽  
Author(s):  
N B Amin ◽  
S Borzak ◽  
S Housholder ◽  
J E Tisdale
Keyword(s):  
Sinus Bradycardia ◽  
Sinus Arrest ◽  
Multiple Episodes

scholarly journals Sinus bradycardia is associated with poor outcome in critically ill patients with COVID-19 due to the B.1.1.7 Lineage

2021 ◽  
Author(s):  
Athanasios Chalkias ◽  
Ioannis Pantazopoulos ◽  
Nikolaos Papagiannakis ◽  
Anargyros Skoulakis ◽  
Eleni Laou ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Sinus Bradycardia ◽  
Poor Outcome

scholarly journals THE HEART THAT WON’T GO ON: SINUS BRADYCARDIA AS THE PRESENTING SIGN OF WORSENING COVID-19 INFECTION

2021 ◽  
Vol 77 (18) ◽  
pp. 2003
Author(s):  
Devina Jagota ◽  
Kim Minh Le ◽  
Denis Ha
Keyword(s):  
Sinus Bradycardia

OP139 Attaining Universal Electrocardiographic Diagnosis Coverage Through Telemedicine

2020 ◽  
Vol 36 (S1) ◽  
pp. 1-1
Author(s):  
Pedro Galvan ◽  
José Ortellado ◽  
Ronald Rivas ◽  
Juan Portillo ◽  
Julio Mazzoleni ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Prevention ◽  
Prevention Program ◽  
Sinus Bradycardia ◽  
Universal Coverage ◽  
Left Ventricular ◽  
Cardiovascular Disease Prevention ◽  
Public Hospitals ◽  
Cross Sectional Survey ◽  
Health Technologies

IntroductionInnovative health technologies, like telemedicine, offer advantageous telediagnostic apps that can improve the health care of populations in remote regions. However, evidence on how these developments can enhance universal coverage for electrocardiographic (ECG) diagnosis to support a cardiovascular disease prevention program is limited. The utility of telemedicine for attaining universal coverage for ECG diagnosis according to the national cardiovascular disease prevention program in Paraguay was investigated.MethodsThis cross-sectional survey included adults (aged 19 to 80 years) and children (aged 1 to 18 years) with a medical prescription. The study was carried out by the Telemedicine Unit to evaluate the utility of a telemedicine net for a countrywide detection and prevention program for cardiovascular disease. The results obtained by the tele-ECG net, which was implemented in sixty public hospitals countrywide, were analyzed and used to verify adherence to the cardiovascular prevention program.ResultsBetween 2014 and 2019, 331,418 remote ECG diagnoses were performed. Of these, eighty-two percent (n = 270,539) were in adults and eighteen percent (n = 60,879) were in children. Among the adult diagnoses, the majority (52%) were pathological and included sinus bradycardia (13%), right bundle branch block (6%), left ventricular hypertrophy (5%), and ventricle repolarization disorder (5%). Among the children, only twenty percent of diagnoses pathological and included sinus bradycardia (11%) and sinus tachycardia (4%). The mean rate of adherence to the prevention program was 38.2 per 1,000 diagnoses performed.ConclusionsThe results showed that telemedicine can significantly enhance coverage for universal ECG diagnosis to support cardiovascular disease prevention and health programs. However, before carrying out the systematic implementation of such a program contextualization using the regional epidemiological profile must be performed.

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