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• W1974232989 abstract "Thirteen patients with sino-atrial disease and alternating episodes of bradycardia and tachycardia are reported. Syncopal spells or dizziness were the most common presenting features. Two patients had thyrotoxicosis and were totally cured after treatment of their endocrine illness. Two others did well on atropine but, for the remaining cases, permanent demand pacing with added digitalis or depressive therapy was needed. The histopathological examination obtained in one case revealed extensive destruction of the sinus node, conspicuous sclerosis of the atrial wall, involvement of the atrio-ventricular node and peripheral left bundle fibers, and marked alterations of the auricular nervous structures. These findings are similar to those described in the very few cases previously reported in the literature. They may account, at the morphological level, for the depressed sinus node and junctional automaticity which was demonstrated in this series by the unusually long cardiac pauses observed after right atrial pacing in three cases and after spontaneous interruption of a tachycardiac episode in another instance. Such histological alterations may also lead to impaired sino-atrial conduction and are, moreover, likely to produce uneven conduction and refractoriness in the atria and, therefore, to favor various types of supraventricular tachyarrhythmias. The pathological as well as clinical data finally indicate that the degenerative process is not always limited to the sinus node or supraventricular structures but frequently extends to the atrioventricular node region or peripheral His-Purkinje system. The latter feature implies that the right ventricular apex should be chosen as the ideal site of pacing for patients with sino-atrial disease." @default.
• W1974232989 created "2016-06-24" @default.
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• W1974232989 date "1973-01-01" @default.
• W1974232989 modified "2023-10-16" @default.
• W1974232989 title "Sino-atrial disease: A report on 13 cases" @default.
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• W1974232989 doi "https://doi.org/10.1016/s0022-0736(73)80052-4" @default.
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