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Microelectrode Array Recording of Sinoatrial Node Firing Rate to Identify Intrinsic Cardiac Pacemaking Defects in Mice
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Sinus node dysfunction and stroke risk: a systematic review and meta-analysis

Haoyu Dong1, Hao Chen1, Tesfaldet Habtemariam Hidru1

  • 1Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.

BMJ Open
|November 17, 2023
PubMed

Insights

Patients with sinus node dysfunction (SND) face a similar stroke risk whether or not they have atrial fibrillation (AF). This highlights the need for stroke prevention strategies in all SND patients.

Area of Science:

  • Cardiology
  • Neurology
  • Clinical Research

Background:

  • The stroke risk associated with cardiac arrhythmia, particularly atrial fibrillation (AF), is well-established.
  • However, the specific stroke risk in patients with sinus node dysfunction (SND), with or without co-existing AF, remains unclear.
  • This study addresses this gap by comparing stroke risk in these patient groups.

Approach:

  • A systematic review and meta-analysis was conducted using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
  • Searches were performed across PubMed, EMBASE, and Cochrane databases up to December 2022.
  • Included studies focused on stroke incidence in patients diagnosed with SND, both with and without AF/atrial flutter.

Key Points:

  • Analysis of 6 papers involving 106,163 patients revealed an average yearly stroke incidence of 1.542% in the SND population.
  • Stroke incidence was comparable between isolated SND (1.587%) and SND with AF (1.660%).
  • Factors associated with increased stroke risk in SND patients included AF, prior thrombotic events, hypertension, and heart failure.

Conclusions:

  • Patients with SND exhibit a similar stroke risk, irrespective of the presence or absence of atrial fibrillation.
  • These findings underscore the importance of considering stroke prevention measures for all individuals with SND.
  • Further research is warranted to evaluate the efficacy of interventions like anticoagulation therapy for stroke prevention in the SND population.
Abstract

Keywords:
anticoagulationmeta-analysisrisk factorssinus node dysfunctionstroke

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