[Differential therapeutic problems in sinus node syndrome--drug or electrical therapy?]

121 hospitalised patients with electrophysiologically ascertained sick sinus syndrome were ambulatorily observed for two and a half years. The knowledge of the electrophysiological parameters allowed in every case an exact estimation of the degree of severity. Patients with preponderantly isolated disturbance of the sino-atrial node automatism, the sino-atrial conduction and the nervous regulation (patients with carotid sinus syndrome) as well as the majority of patients with bradycardia-tachycardia-syndrome were conservatively treated. Patients with high-degree combined disturbances of the sinus node partial functions were electrically treated. Every cardiac syncope in the medicamentously treated sick sinus node syndrome is the absolute indication for a pacemaker implantation. The further observation in the outpatient department showed that in many patients with symptomatic sick sinus node syndrome an attempt of conservative treatment is justified.