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Stroke in paced patients with sick sinus syndrome: influence of left atrial function and size

A V Mattioli1, E Tarabini Castellani, G Mattioli

  • 1Department of Cardiology, University of Modena, Italy. mattioli.anna.vittoria@unimo.it

Cardiology
|October 12, 1999
PubMed

Insights

Patients with sick sinus syndrome (SSS) face a high risk of stroke. Low atrial function and enlarged left atrium predict cerebral ischemia in paced SSS patients, aiding risk identification.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Sick sinus syndrome (SSS) is associated with an increased risk of cerebrovascular events.
  • Understanding stroke prevalence and predictors in SSS patients is crucial for risk stratification.

Purpose of the Study:

  • To determine the prevalence of cerebral ischemia in patients with SSS.
  • To investigate the role of atrial size and function in predicting stroke in these patients.

Main Methods:

  • Prospective study of 100 SSS patients without atrial fibrillation receiving pacemakers.
  • Cranial CT scans performed at baseline and 24 months.
  • Clinical and echocardiographic assessments, including atrial size and function.
  • Multivariate regression analysis to identify predictors of cerebral ischemia.

Main Results:

  • Cerebral ischemia occurred in 18% of patients.
  • Predictors of embolism included age >65 years, low atrial ejection force, and dilated left atrium with spontaneous echo contrast.
  • These factors identified high-risk individuals within the paced SSS cohort.

Conclusions:

  • Age, atrial function, and left atrial dimensions are significant predictors of stroke in paced SSS patients.
  • These findings aid in identifying SSS patients at higher risk for peripheral embolism.
  • Risk stratification can guide preventative strategies in this population.

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