Tachycardia-bradycardia syndrome (so-called "sick sinus syndrome"). Pathology, mechanisms and treatment |
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| Authors: | B M Kaplan R Langendorf M Lev A Pick |
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| Affiliation: | 1. From the Cardiovascular Institute, Michael Reese Hospital and Medical Center, Chicago, Ill. USA;2. From the Congenital Heart Disease Research and Training Center, Hektoen Institute for Medical Research, Chicago, Ill. USA;3. From the Department of Pathology, Northwestern University Medical School, Chicago, Ill. USA;4. From the Pritzker School of Medicine, University of Chicago, Chicago, Ill. USA;5. From the Abraham Lincoln School of Medicine, University of Illinois, Chicago, Ill. USA;6. From the Chicago Medical School, University of Health Sciences, Chicago, Ill. USA;7. From the Loyola University, Stritch School of Medicine, Chicago, Ill. USA |
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| Abstract: | The tachycardia-bradycardia syndrome consists of paroxysmal atrial fibrillation, flutter or tachycardia followed by sinoatrial block or sinus arrest resulting in Stokes-Adams attacks. Detailed histologie findings of the conduction system of 2 patients with this entity correlated well with the clinical observation of cardiac rhythm disturbances in the sinus node, atria and atrioventricular (A-V) junction. Eight other patients with the syndrome were studied clinically. The mechanisms (as revealed by the electrocardiogram) producing the bradycardia phase include depression of pacemaker function (arrest) or of conduction (exit block) of the sinus impulse, or both, plus depression of A-V junctional impulse formation. Proper therapy usually requires electrical pacing in conjunction with administration of digitalis or propranolol, or both. Our findings suggest that the term “sick sinus syndrome” is an inaccurate and inappropriate synonym for the tachycardia-bradycardia syndrome. |
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| Keywords: | Address for reprints: Alfred Pick MD Cardiovascular Institute Michael Reese Hospital and Medical Center Chicago Ill. 60616. |
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