Sinus node dysfunction and stroke risk: a systematic review and meta-analysis

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.