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      Comparative Study of Electrophysiological and Holter Monitoring Data in Estimating Sinoatrial Function


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          To study the diagnostic possibilities and mechanisms involved in sinus node dysfunction (SND), 26 patients with sick sinus syndrome were evaluated by basic electrophysiological tests before and after autonomic blockade, and by Holter monitoring. Based on intrinsic heart rate (IHR), two groups, a normal and a pathologic one, were separated. With Holter recordings, significant differences were manifested in minimal heart rate during sleeping and also in sinus cycles averaged for 24 h between the two groups. In patients with pathological IHR (n = 9) abnormal intrinsic rhythmicity were verified by electrophysiological means, while we found positive ECGs referring to sinoatrial dysfunction during the first 24 h of rhythm recording. The group of normal IHR (n = 17) covers patients with intrinsic SND (intrinsic SA block, 3/17 patients) and patients (14/17) where the electrophysiologic properties of the pacemaker cells were normal: normal intrinsic recovery time, gradual return to the stable intrinsic sinus cycle length in the postpacing secondary cycles, biphasic postextrasystolic patterns with a well-estimated intrinsic sinoatrial conduction time. Repeated Holter recording (total 26 × 24 h) revealed severe bradycardia (2 cases), SA block (4 cases), SA arrest (2 cases), tachybradyarrhythmia (1 case). Electrophysiological studies have a low diagnostic value in autonomic SND; repeated rhythm monitoring is obviously the best complementary method for appreciating the role and significance of autonomic tone in sick sinus syndrome.

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          Author and article information

          S. Karger AG
          07 November 2008
          : 70
          : 4
          : 184-193
          University of Aix-Marseille, Marseille, France
          173592 Cardiology 1983;70:184–193
          © 1983 S. Karger AG, Basel

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          : 15 February 1983
          : 27 May 1983
          Page count
          Pages: 10
          Original Paper

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Autonomic and intrinsic sinus node dysfunction,Holter monitoring,Electrophysiological tests,Autonomic blockade


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