Appraisal of sinus nodal recovery time in patients with sick sinus syndrome

Gupta, Prem K.; Lichstein, Edgar; Chadda, Kul D.; Baduí, Elías

doi:10.1016/0002-9149(74)90025-3

Cited by 117 publications

(17 citation statements)

References 21 publications

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“…Table VI shows AH interval slightly increased (60 msec) in only 2 patients (cases 5,14). In these 6 patients with atrioventricular conduction defects, atrial pacing usually in duced a second-degree atrioventricular block (Luciani-Wenckebach, in cases 7,17; 2:1 AVB in case 13) at paced rates equal or inferior to 110/min.…”

Section: Resultsmentioning

confidence: 91%

“…Gupta et al [14] found this interval ranging from 0 to 375 msec in 15 control subjects. As in previous studies, our results show that patients with sinus bradycardia do not include a homogeneous group.…”

Section: Discussionmentioning

confidence: 89%

“…Several clinical studies [14,27,28,30,33] tried to assess sinus node function by measuring SRT. Narnia et al…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Autonomic Influences and Cardiac Conduction in Patients with Sinus Node Disease

Chiche¹,

Lellouch²,

Denizeau³

1976

Cardiology

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Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 89%

See 1 more Smart Citation

Autonomic Influences and Cardiac Conduction in Patients with Sinus Node Disease

Chiche¹,

Lellouch²,

Denizeau³

1976

Cardiology

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“…Thereafter the usefulness of the sinus node recovery time has been reported by many authors.13)-17) On the other hand the limitation of overdrive pacing in evaluating sinus node function has been shown by Gupta et al,18) who claimed that an abnormal SNRT could be demonstrated in only 35% of sick sinus syndrome patients, and the usefulness of ART observed by Holter electrocardiographic recordings has been demonstrated by Reiffel et al, 19) who showed that ART observed by atrial pacing had a false positive rate of 40% and a false negative rate of 26% comparing with Holter electrocardiographic abnormalities.…”

Section: Discussionmentioning

confidence: 95%

Significance of the automaticity recovery phase following tachycardic overdrive.

Otsuka

Yanaga²

1982

Jpn Heart J

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“…6) with interelectrode distances of 10 mm were introduced percutaneously through the femoral vein of each patient while under local anesthesia; catheters were positioned in the high right atrium in the region of the sinus node. One catheter was used for recording sinus node electrograms, [8][9][10][11][12][13][14][15][16][17][18][19][20][21] and the other for atrial pacing. The distal poles of catheter No.…”

Section: Methodsmentioning

confidence: 99%

New application of direct sinus node recordings in man: assessment of sinus node recovery time.

Gomes¹,

Hariman²,

Chowdry³

1984

Circulation

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Sinus node recovery time (SNRT) is frequently used to assess sinus node function in patients with suspected sick sinus syndrome (SSS). Although SNRT is assumed to reflect sinus node automaticity, this assumption remains unproven. The purpose of this study was (1) to test the hypothesis that SNRT in patients with and without SSS reflects sinus node automaticity, and (2) to assess the role of sinoatrial conduction time in the measurement of SNRT. A total of 16 patients (mean + SD age 63 ± 9 years), seven of which had SSS, form the basis of this report. An electrogram of the sinus node was obtained for each of the 16 patients, and overdrive pacing was performed in each at cycle lengths of 1000 to 300 msec. SNRT was measured (1) on the sinus node electrogram (direct method, measuring SNRTd) as the interval from the last pacing stimulus artifact to the onset of the upstroke slope of first postpacing sinus beat and (2) on the high right atrial electrogram (indirect method, measuring SNRTi). Results were as follows: (1) The longest SNRTd was significantly shorter than the longest SNRTi (989 + 304 vs 1309 ± 356 msec, p < .001). (2) For the first postpacing sinus beat there was a significant prolongation of sinoatrial conduction time as compared with that for sinus beats before pacing (319 + 152 vs 99 + 35 msec, p < .001). Sinoatrial conduction time normalized within 3.6 + 0.96 postpacing sinus beats. (3) At the pacing cycle length that resulted in the longest recovery time, sinus node depression was seen in 56% of patients, sinus node acceleration was noted in 26%, and no appreciable change in sinus node automaticity was observed in 19%. (4) Sinoatrial conduction time for the sinus beat before pacing and that for the first postpacing beat was longer in patients with SSS when compared with in patients without SSS. (5) In patients with SSS the abnormal SNRTi, when corrected for the degree of prolongation of sinoatrial conduction time for the first postpacing beat, became normal in five of six patients. We conclude that (1) SNRTi reflects both sinus node automaticity and sinoatrial conduction time, whereas SNRTd reflects sinus node automaticity, (2) overdrive atrial pacing results in marked prolongation of sinoatrial conduction time for the first postpacing beat, which is longer in patients with SSS when compared with in those without SSS, and (3) in patients with SSS the inference of abnormal sinus node automaticity on the basis of a prolonged corrected SNRTi is usually incorrect. Circulation 70, No. 4, 663-671, 1984. THE PHENOMENON of postpacing depression of cardiac pacemakers' -7 has been used to evaluate sinus node function in man.8-7 Clinical studies have focused on the response of the human sinus node to atrial pacing at rates above the sinus rate. The method has been used to determine the time required for a sinus beat to resume activity after abrupt cessation of atrial pacing. This sinus node recovery time (SNRT) has been used in the evaluation of sinus node function in patients with sick sinus syndrom...

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Appraisal of sinus nodal recovery time in patients with sick sinus syndrome

Cited by 117 publications

References 21 publications

Autonomic Influences and Cardiac Conduction in Patients with Sinus Node Disease

Autonomic Influences and Cardiac Conduction in Patients with Sinus Node Disease

Significance of the automaticity recovery phase following tachycardic overdrive.

New application of direct sinus node recordings in man: assessment of sinus node recovery time.

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