Chronic sinus node disease: natural course and indications for pacing

The natural history of sinus node disease has been analysedfrom reported as well as original data. Because of the widespreaduse of pacemakers in sinus node disease the perfect study ofits true prognosis will probably never be made. Nevertheless,available data strongly indicate that the outlook for identifiedpatients with the disorder who do not have sever symptoms isfavorable. Even for the severely symptomatic group, the prognosisseems to be much better than in atrioventricular conductiondisease. Pacemaker implantations in this condition should therefore,in general, be restricted to the symptomatic patient in whomthe symptoms have been shown to coincide with bradycardia. International differences in the extent of pacing use have beenanalysed from current statistics. It is concluded that differentattitudes to pacing in sinus node disease account for a substantialpart of these differences