The Sick Sinus Syndrome in Atrial Disease

Pathological studies in sinoatrial disorder (sick sinus syndrome).

“…There have been papers from several countries describing its various clinical features, and modes of presentation, under such synonvms as sick sinus or lazy sinus syndrome (Bouvrain et al, 1967;Ferrer, 1968;Shaw and Eraut, 1969). Furthermore, the treatment of the condition using both electrical and pharmacological methods and its mortality and morbidity have been described (Eraut and Shaw, 1971;Aroesty et al, 1974), and a complete monograph on the subject has recently been published (Ferrer, 1974).…”

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

“…In the clinical evaluation of patients with sick sinus syndrome it is important that the patient's heart rate be considered in the context of the entire clinical picture (Consolazio et al, 1951;Ferrer, 1968;Rosen et al, 1971;Ferrer, 1973;Kaplan et al, 1973). For example, a heart rate of 75 beats/min in the face of high fever is not appropriate and should suggest the possibility of sinoatrial node disease.…”

“…Sick sinus syndrome is often associated with underlying heart disease . * but in others may be the result of primary disease of the specialised pacemaker and conducting tissues, that is the sinoatrial node, atrioventricular node, and the subjunctional tissues (Ferrer, 1968;Rosen et al, 1971;Rubenstein et al, 1972;Ferrer, 1973; A B Kaplan et al, 1973). Associated disease of the atrial (SSS) (controls) (trained) muscle may be present in these patients (Theryet al, 1977).…”

“…Diseases of the sinoatrial node can present in a variety of clinical patterns including persistent bradycardia, sinus arrest, and sinoatrial node exit block (Ferrer, 1968(Ferrer, , 1973. In some patients, the bradycardia alternates with tachyarrhythmias, the 'bradycardia-tachycardia' syndrome (Short, 1954;Kaplan et al, 1973).…”

“…All of these patterns are known collectively as the 'sick sinus syndrome'. Previous studies of patients with the sick sinus syndrome have assessed the function of the sinus node at rest, with atrial pacing, and with isoprenaline infusion (Ferrer, 1968;Rosen et al, 1971;Mandel et al, 1972;Ferrer, 1973;Strauss et al, 1973;Mandel et al, 1975;Benditt et al, 1976). We have studied the heart rate response to maximum exercise and found 'Supported in part by a Program Project Grant from the National Heart, Lung and Blood Institute, Bethesda, Maryland, and by a grant from the Oregon Heart Association.…”