Characterisation of heart rate response to exercise in the sick sinus syndrome.

Holden, William L.; McAnulty, John H.; Rahimtoola, S H

doi:10.1136/hrt.40.8.923

Cited by 52 publications

(11 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…36,37 Chronotropic incompetence is usually diagnosed by exercise testing or ambulatory monitoring. 22,38,39 The diagnosis of neurocardiogenic syncope, also commonly called vasovagal syncope, can usually be made on clinical grounds. If the diagnosis is uncertain, testing while the patient is lying in a head-up position on a tilt table may be used to provoke an episode of syncope and confirm changes in heart rate and blood pressure during such episodes.…”

Section: Discussionmentioning

confidence: 99%

“…Proposed definitions have included the failure to reach a heart rate that is 85 percent of the age-predicted maximum (220¡age in years) at peak exercise, the failure to achieve a heart rate of 100 beats per minute, or a maximal heart rate more than 2 SD below that in a control population. [22][23][24][25] …”

Section: Normal Anatomy and Physiology Of The Conduction Systemmentioning

confidence: 99%

See 1 more Smart Citation

The Evaluation and Management of Bradycardia

2000

N Engl J Med

242

123

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Normal Anatomy and Physiology Of The Conduction Systemmentioning

confidence: 99%

The Evaluation and Management of Bradycardia

2000

N Engl J Med

242

123

View full text Add to dashboard Cite

show abstract

“…A 12‐lead electrocardiogram was recorded after exercise. On exercise, patients with SSS have a reduced heart rate response as compared with normal patients . The patients underwent stair climbing or used an ergometer depending on their physical activity.…”

Section: Methodsmentioning

confidence: 99%

“…On exercise, patients with SSS have a reduced heart rate response as compared with normal patients. 5 The patients underwent stair climbing or used an ergometer depending on their physical activity. When the patients used the ergometer, the exercise load was gradually increased to their maximum capacity of exercise.…”

Section: Exercise Electrocardiogrammentioning

confidence: 99%

Cardiac iodine‐123‐metaiodobenzylguanidine scintigraphy may be useful to identify pathologic from physiologic sinus bradycardia

Sunaga

Masuda

Fujita

et al. 2017

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…Established normal values for the sinus node rate response for standard stress-testing protocols according to age and sex are available [7].…”

Section: Clinical Evaluationmentioning

confidence: 99%

Disorders of sinus function

Mandel

Jordan

Karagueuzian

1999

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

Sinus node dysfunction is a common entity with significant clinical implications. Establishing a diagnosis may, on occasion, tax the skills of the clinician. Many causes have been cited, but no single factor appears to be established. Immunologic abnormalities may play a part in the etiologic process. Clinical invasive electrophysiology studies may be used to establish a diagnosis. In general, medical therapy must be integrated. Controversy exists regarding the best method of permanent pacing. Treatment may need to be individualized to the type of arrhythmia noted. Long-term prognosis is a large factor in choice of therapy, related to the underlying disease. Prevention of atrial fibrillation may occur with dual-chamber pacing; however, anticoagulation appears essential in this patient subgroup. The 5-year mortality rate in these patients is high and does not appear to be significantly improved with artificial pacing. Mortality is prominently influenced by the coexistence of cardiovascular and valvular heart disease. Patients who die do not differ substantially from survivors with regard to type of sinus dysfunction, occurrence of tachyarrhythmia, or distal conduction abnormalities. The survival rate in patients with sick sinus syndrome and congestive heart failure is significantly lower, and the incidence of embolic events remains high in patients with permanent pacing and the sick sinus syndrome. Thus, it has been proposed that all patients exhibiting the bradycardia-tachycardia syndrome be fully anticoagulated. The incidence of atrial fibrillation is significantly lower in patients with atrial demand pacing (22.3% versus 3.9%) than in patients with ventricular pacing and is accompanied by a decreased incidence of systemic embolization (13% versus 1.6%). Reports comparing survival with use of dual-chamber pacing versus ventricular pacing are encouraging in patients with congestive heart failure. At present, the natural history of the disease is unknown; furthermore, clinical risk factors for the development of symptoms have not been defined, and no electrophysiologic measure of sinus node function has been demonstrated to have reliable predictive value. Therefore, common practice has been to withhold pacemaker therapy in the asymptomatic patient.

show abstract

Characterisation of heart rate response to exercise in the sick sinus syndrome.

Cited by 52 publications

References 30 publications

The Evaluation and Management of Bradycardia

The Evaluation and Management of Bradycardia

Cardiac iodine‐123‐metaiodobenzylguanidine scintigraphy may be useful to identify pathologic from physiologic sinus bradycardia

Disorders of sinus function

Contact Info

Product

Resources

About