Systemic embolism in chronic sinoatrial disorder

Area of Science:

• Cardiology
• Vascular Medicine
• Electrophysiology

Background:

• Systemic embolism poses a significant risk in patients with cardiac rhythm disorders.
• Chronic sino-atrial disorder is associated with various arrhythmias, including bradycardia-tachycardia syndrome.

Purpose of the Study:

• To estimate the prevalence of systemic embolism in patients diagnosed with chronic sino-atrial disorder.
• To compare embolism rates between patients with sino-atrial disorder and controls with chronic complete heart block.

Main Methods:

• A cohort of 100 patients with chronic sino-atrial disorder was assessed for evidence of systemic embolism.
• A control group of 712 patients with chronic complete heart block, matched for age and sex, was used for comparison.
• A second patient group (n=41) with chronic ventricular bradycardia and atrial flutter/fibrillation was also analyzed.

Main Results:

• Systemic embolism was detected in 16% of patients with sino-atrial disorder, with 15% having bradycardia-tachycardia syndrome.
• Embolism prevalence in sino-atrial disorder patients (16%) was significantly higher than in controls (1.3%, P < 0.001).
• Patients with ventricular bradycardia and atrial flutter/fibrillation showed a higher embolism rate (7.3%) compared to controls (P < 0.05).

Conclusions:

• Chronic sino-atrial disorder, especially bradycardia-tachycardia syndrome, is linked to a high prevalence of systemic embolism.
• Impaired atrial function is identified as a critical factor for intracardiac thrombosis and subsequent embolization.
• The risk of embolization persists even with conversion to stable atrial fibrillation, and paroxysmal supraventricular tachycardia elevates this risk.