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Related Experiment Videos

Sinus node function after autonomic blockade in normals and in sick sinus syndrome.

K K Sethi, S Jaishankar, J Balachander

    International Journal of Cardiology
    |June 1, 1984
    PubMed
    Summary

    Electrophysiologic studies reveal that most sick sinus syndrome patients have intrinsic sinus node dysfunction, not just autonomic issues. Autonomic blockade worsened corrected sinus node recovery time in many patients, indicating underlying automaticity problems.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Electrophysiology

    Background:

    • Sick sinus syndrome (SSS) is a complex cardiac arrhythmia.
    • Understanding the underlying pathophysiology of SSS is crucial for effective treatment.
    • Autonomic nervous system influence on sinus node function is significant.

    Purpose of the Study:

    • To differentiate between intrinsic sinus node abnormality and autonomic dysregulation in SSS.
    • To evaluate the impact of autonomic blockade on sinus node recovery time and sinoatrial conduction time.
    • To identify predictors of abnormal electrophysiologic findings in SSS patients.

    Main Methods:

    • Electrophysiologic studies were conducted on 33 SSS patients and 10 controls.
    • Total autonomic blockade was achieved using propranolol and atropine.

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  • Measurements included corrected sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) before and after blockade.

    • Main Results:

    • Corrected SNRT was abnormal in 76% of SSS patients after autonomic blockade, significantly higher than baseline (48.5%).
    • Patients with low intrinsic heart rate after blockade showed a higher incidence of abnormal corrected SNRT and SACT.
    • Sinoatrial conduction time (SACT) also shortened post-blockade, with abnormalities noted in a subset of patients.

    Conclusions:

    • The majority of SSS cases (76%) exhibit intrinsic sinus node automaticity defects.
    • A minority of SSS patients (24%) show disturbed autonomic regulation as the primary cause.
    • Abnormal intrinsic heart rate correlates with more severe sinus node dysfunction and potential perinodal conduction issues.